Provider Demographics
NPI:1780213546
Name:SAMS, TYLER DOANE (DO)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:DOANE
Last Name:SAMS
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 1:1020 N HIGHLAND AVE STE C
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-2494
Mailing Address - Country:US
Mailing Address - Phone:615-396-6454
Mailing Address - Fax:
Practice Address - Street 1:1020 N HIGHLAND AVE STE A
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-2494
Practice Address - Country:US
Practice Address - Phone:615-396-6454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-03
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5146207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine