Provider Demographics
NPI:1003050493
Name:AUSCHWITZ, TYLER SEAN
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:SEAN
Last Name:AUSCHWITZ
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 1:2000 SOUTH WHEELING, STE 200
Mailing Address - Street 2:ST. JOHNS NEUROSCIENCE INSTITUTE
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104
Mailing Address - Country:US
Mailing Address - Phone:918-748-7854
Mailing Address - Fax:
Practice Address - Street 1:2000 SOUTH WHEELING, STE 200
Practice Address - Street 2:ST. JOHNS NEUROSCIENCE INSTITUTE
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104
Practice Address - Country:US
Practice Address - Phone:918-748-7854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK31242207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty