Provider Demographics
NPI:1629648522
Name:RAWLINS, TYLER MCKAY (OD)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:MCKAY
Last Name:RAWLINS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 N DIGITAL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-6694
Mailing Address - Country:US
Mailing Address - Phone:801-876-6000
Mailing Address - Fax:385-235-6111
Practice Address - Street 1:3333 N DIGITAL DR STE 300
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-6694
Practice Address - Country:US
Practice Address - Phone:801-876-6000
Practice Address - Fax:385-235-6111
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12362257-9934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist