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NPI Code Detail

MEDICARE: TYLER MACIAS

MEDICARE: TYLER MACIAS
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
1237700000XHearing Instrument Specialist17001419AIN

General Provider Information

NPI Number : 1710347224
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER MACIAS
Provider Business Mailing Address
First Line : 3843 MOLLER RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46254-2930
Country : US
Telephone Number : 317-291-3376
Fax Number : 317-291-3746
Provider Business Practice Location Address
First Line : 3843 MOLLER RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46254-2930
Country : US
Telephone Number : 317-291-3376
Fax Number : 317-291-3746
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2016
Last Update Date : 02/25/2016

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Directions to “ TYLER MACIAS ” Practice Location

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