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NPI Code Detail

MEDICARE: TRACI L TYGER PA-C

MEDICARE: TRACI L TYGER PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantMA003210LPA

General Provider Information

NPI Number : 1619971108
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACI L TYGER PA-C
Provider Business Mailing Address
First Line : PO BOX 447
Second Line :
City : DU BOIS
State : PA
Zip : 15801-0447
Country : US
Telephone Number : 814-375-3535
Fax Number : 814-375-3529
Provider Business Practice Location Address
First Line : 100 HOSPITAL AVE
Second Line : HAHNE REGIONAL CANCER CENTER/RADIATION ONCOLOGY
City : DU BOIS
State : PA
Zip : 15801-1440
Country : US
Telephone Number : 814-375-3535
Fax Number : 814-375-3529
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 06/23/2011

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