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NPI Code Detail

MEDICARE: MICHAEL TYLER M.D.

MEDICARE: MICHAEL TYLER M.D.
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
12084P0800XPsychiatry PhysicianMD00030739WA
22084P0800XPsychiatry Physician156207CA

General Provider Information

NPI Number : 1902868847
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL TYLER M.D.
Provider Business Mailing Address
First Line : 114 W 7TH ST STE 900
Second Line :
City : AUSTIN
State : TX
Zip : 78701-3013
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11670 ATWOOD RD
Second Line :
City : AUBURN
State : CA
Zip : 95603-9522
Country : US
Telephone Number : 530-887-2800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2006
Last Update Date : 06/30/2023

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