Provider Demographics
NPI:1376920942
Name:ENDERS, J TYLER (DO)
Entity Type:Individual
Prefix:
First Name:J TYLER
Middle Name:
Last Name:ENDERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:J
Other - Middle Name:TYLER
Other - Last Name:ENDERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:10200 N 92ND ST STE 225
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4536
Mailing Address - Country:US
Mailing Address - Phone:480-697-4824
Mailing Address - Fax:480-697-4825
Practice Address - Street 1:10200 N 92ND ST STE 225
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4536
Practice Address - Country:US
Practice Address - Phone:480-697-4824
Practice Address - Fax:480-697-4825
Is Sole Proprietor?:No
Enumeration Date:2015-05-02
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101025644207X00000X
AZ009126207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery