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Individual
TYLER WITZEL
Active
Individual
TYLER WITZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23869
NV
207Q00000X
Family Medicine Physician
OP60949403
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972908150
—
NV
01
—
23869
STATE LICENSE
NV
Enumeration date
10/30/2014
Last updated
07/10/2023
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