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Individual
DR. TYLER JOHN SOUTHWELL
Active
Individual
DR. TYLER JOHN SOUTHWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301095075
MI
207Q00000X
Family Medicine Physician
Primary
47542
AZ
Other
Enumeration date
07/27/2008
Last updated
01/26/2021
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