Provider Demographics
NPI:1083636021
Name:APRIL B TYLER DO PC
Entity Type:Organization
Organization Name:APRIL B TYLER DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:B
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:810-629-6996
Mailing Address - Street 1:1361 N LONG LAKE RD
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-8867
Mailing Address - Country:US
Mailing Address - Phone:810-629-6996
Mailing Address - Fax:810-629-0614
Practice Address - Street 1:1361 N LONG LAKE RD
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-8867
Practice Address - Country:US
Practice Address - Phone:810-629-6996
Practice Address - Fax:810-629-0614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101011859207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE82123Medicare UPIN
MI0N58130Medicare PIN