Individual
TYLER BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 20TH ST STE 606, KNOXVILLE, TN 37916-1863
(865) 546-8040
Mailing address
1719 COVE OAK LN, KNOXVILLE, TN 37909-1272
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
56990
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/15/2016
Last updated
08/31/2020
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