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NPI Code Detail

MEDICARE: TYLER PATRICK MAGEE

MEDICARE: TYLER PATRICK MAGEE
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.166297OH

General Provider Information

NPI Number : 1871081828
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER PATRICK MAGEE
Provider Business Mailing Address
First Line : PO BOX 3095
Second Line :
City : DUBLIN
State : OH
Zip : 43016-0046
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 111 W WATER ST
Second Line :
City : CHILLICOTHEE
State : OH
Zip : 45601-2452
Country : US
Telephone Number : 740-851-4432
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2018
Last Update Date : 02/22/2023

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