Provider Demographics
NPI:1114207875
Name:VUKMER, TYLER OWEN (DO)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:OWEN
Last Name:VUKMER
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 1:100 STEELE ST APT 317
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5251
Mailing Address - Country:US
Mailing Address - Phone:518-727-2110
Mailing Address - Fax:
Practice Address - Street 1:2970 QUEBEC ST STE 200
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-2931
Practice Address - Country:US
Practice Address - Phone:303-426-4525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO2816208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice