Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 3120 | TN |
NPI | 1902389091 |
---|---|
Provider Name | Tyler Hurst |
First Address | Nashville, TN 37204-3117 |
Second Address | Nashville, TN 37204-3117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2018 |
Last Update Date | 13/09/2018 |