Provider Demographics
NPI:1336384809
Name:TISCHLER, IRWIN W (DO)
Entity Type:Individual
Prefix:DR
First Name:IRWIN
Middle Name:W
Last Name:TISCHLER
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 1:4638 E BERNEIL DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-5500
Mailing Address - Country:US
Mailing Address - Phone:602-538-2200
Mailing Address - Fax:
Practice Address - Street 1:4638 E BERNEIL DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-5500
Practice Address - Country:US
Practice Address - Phone:602-538-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2738207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZC39502Medicare UPIN