Provider Demographics
NPI:1073945424
Name:NORTON, TYLER J (PA-C)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:J
Last Name:NORTON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:400N PARK AVE 1A
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80424-8709
Mailing Address - Country:US
Mailing Address - Phone:970-547-9200
Mailing Address - Fax:970-262-2196
Practice Address - Street 1:735 US HIGHWAY 24
Practice Address - Street 2:
Practice Address - City:LEADVILLE
Practice Address - State:CO
Practice Address - Zip Code:80461-3978
Practice Address - Country:US
Practice Address - Phone:719-486-0500
Practice Address - Fax:719-486-3966
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COPA.0003762363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical