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Individual

TYLER M NEITLICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
100 E CAMPUS VIEW BLVD STE 100, COLUMBUS, OH 43235-8628
(614) 340-7740
Mailing address
17310 WRIGHT ST STE 103, OMAHA, NE 68130-2405
(833) 228-6889
(877) 853-0376

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
12500C
WY
2085R0202X
Diagnostic Radiology Physician
16148
ND
2085R0202X
Diagnostic Radiology Physician
Primary
ME99487
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ME99487
MEDICAL LICENSE
FL
Enumeration date
07/17/2007
Last updated
11/05/2024
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