Individual
MYLES ELDON TIESZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1601 SIOUX VALLEY DR, LUVERNE, MN 56156
(507) 283-4476
(507) 283-9086
Mailing address
1601 SIOUX VALLEY DR, LUVERNE, MN 56156-4500
(507) 283-4476
(507) 283-9086
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
3813
SD
208600000X
Surgery Physician
38654
IA
208600000X
Surgery Physician
Primary
64861
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46045455601
—
NE
05
—
7300264
—
SD
Enumeration date
05/16/2006
Last updated
02/22/2019
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