Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | R-10970 | IA |
N | 111NI0900X | Internist | R-10970 | IA |
Y | 207W00000X | Ophthalmologist | MD-48245 | IA |
N | 207W00000X | Ophthalmologist | R-10970 | IA |
NPI | 1023547395 |
---|---|
Provider Name | Dr. Tyler S Quist |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2017 |
Last Update Date | 19/07/2021 |