Provider Demographics
NPI:1134614381
Name:LOOYSEN, TYLER (MD, MPH)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:LOOYSEN
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Gender:M
Credentials:MD, MPH
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Other - First Name:
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Mailing Address - Street 1:4450 31ST AVE S STE 200
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-4598
Mailing Address - Country:US
Mailing Address - Phone:701-293-9829
Mailing Address - Fax:701-293-0111
Practice Address - Street 1:4450 31ST AVE S STE 200
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-4598
Practice Address - Country:US
Practice Address - Phone:701-293-9829
Practice Address - Fax:701-293-0111
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2024-07-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ND21234207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology