Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 35086806 | OH |
N | 207X00000X | Orthopaedic Surgeon | A108880 | CA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | A108880 | CA |
NPI | 1386650802 |
---|---|
Provider Name | Tyler G Smith |
First Address | Roseville, CA 95661-2866 |
Second Address | Roseville, CA 95661-2866 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 20/12/2021 |