Provider Demographics
NPI:1821437971
Name:QUEST, TYLER LEE (MD)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:LEE
Last Name:QUEST
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 1:1119 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2905
Mailing Address - Country:US
Mailing Address - Phone:307-266-2772
Mailing Address - Fax:
Practice Address - Street 1:1119 E 3RD ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2905
Practice Address - Country:US
Practice Address - Phone:307-266-2772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY11099A207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology