Provider Demographics
NPI:1457950297
Name:NAEGELE, TYLER DAVID (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:DAVID
Last Name:NAEGELE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3465 PARK ST UNIT 303
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-2592
Mailing Address - Country:US
Mailing Address - Phone:614-886-2920
Mailing Address - Fax:
Practice Address - Street 1:887 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-1704
Practice Address - Country:US
Practice Address - Phone:740-775-8467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPHARMACIST183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist