Provider Demographics
NPI:1013409580
Name:SHIFLETT, TYLER ROBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:ROBERT
Last Name:SHIFLETT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 E RIVER RD STE 112
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-6577
Mailing Address - Country:US
Mailing Address - Phone:520-888-3553
Mailing Address - Fax:
Practice Address - Street 1:2200 E RIVER RD STE 112
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-6577
Practice Address - Country:US
Practice Address - Phone:520-888-3553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2023-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR30622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry