Individual
TYLER JORDAN BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
920 STANTON L YOUNG BLVD # WP1140, OKLAHOMA CITY, OK 73104-5036
(405) 271-4700
Mailing address
5208 BING CIR, EDMOND, OK 73034-7453
(316) 613-1747
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
210453
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/19/2021
Last updated
02/01/2023
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