MEDICARE: TYLER SHERWOOD 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
1	363A00000X	Physician Assistant	2564	TN

General Provider Information

NPI Number	:	1639588221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYLER SHERWOOD PA-C

Provider Business Mailing Address
First Line	:	907 SHERWOOD DR
Second Line	:
City	:	UNION CITY
State	:	TN
Zip	:	38261-1915
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1229 S 1ST ST
Second Line	:
City	:	UNION CITY
State	:	TN
Zip	:	38261-5014
Country	:	US
Telephone Number	:	731-885-8282
Fax Number	:	731-885-1998

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2014
Last Update Date	:	08/07/2014

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Directions to “ TYLER SHERWOOD PA-C” Practice Location

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