Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 68512491205 | UT |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 6851249-1205 | UT |
NPI | 1154596864 |
---|---|
Provider Name | Dr. Andrew Tyser |
First Address | Salt Lake City, UT 84141-3026 |
Second Address | Salt Lake City, UT 84108-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2008 |
Last Update Date | 20/12/2021 |