Green, Tyler Douglas

Green, Tyler Douglas is an individual health care provider with primary practice located at 7901 Schatz Pointe Dr Suite A, Dayton OH 45459-3856. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Green, Tyler Douglas can be contacted via phone (937) 438-9841.

Contact Information

Primary practice address
7901 Schatz Pointe Dr Suite A Dayton OH 45459-3856
Phone: (937) 438-9841
Fax: (937) 438-9851
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X COA.15402-NP Ohio

Profile Details

NPI number 1700217494
LBN Legal business name Green, Tyler Douglas
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2013
Last updated Jan 26th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700217494 NPPES
Ohio MEDICAID 0097903

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