Provider Demographics
NPI:1922627710
Name:MCGEE, TYLER P
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:P
Last Name:MCGEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1588 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST BARNSTABLE
Mailing Address - State:MA
Mailing Address - Zip Code:02668-1139
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:125 METRO CENTER BLVD STE 2000
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1785
Practice Address - Country:US
Practice Address - Phone:401-921-9202
Practice Address - Fax:401-921-9212
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-11
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA7994363A00000X
390200000X
RIPA01303363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program