Individual
TYLER DANIEL SHARPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 S JACKSON ST, ACB, A3H02, LOUISVILLE, KY 40202-1622
(502) 852-7041
Mailing address
550 S JACKSON ST, ACB, A3H02, LOUISVILLE, KY 40202-1622
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
47962
KY
207R00000X
Internal Medicine Physician
R3033
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100248210
—
KY
Enumeration date
04/04/2012
Last updated
08/27/2015
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