Provider Demographics
NPI:1437449949
Name:LASH, TYLER DONALD (MD)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:DONALD
Last Name:LASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 KINGS HWY
Mailing Address - Street 2:SUITE 340
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103-3951
Mailing Address - Country:US
Mailing Address - Phone:318-212-8620
Mailing Address - Fax:318-212-8625
Practice Address - Street 1:2600 KINGS HWY STE 340
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-3951
Practice Address - Country:US
Practice Address - Phone:318-212-8620
Practice Address - Fax:318-212-8625
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA304955207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology