Individual
DR. TYLER JOHN SOUTHWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10599 N TATUM BLVD STE F151, PARADISE VALLEY, AZ 85253-1053
(480) 991-9271
(844) 284-7758
Mailing address
6033 E CARNATION CIR, PHOENIX, AZ 85018-6716
(616) 560-4160
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301095075
MI
207Q00000X
Family Medicine Physician
Primary
47542
AZ
Other
Enumeration date
07/27/2008
Last updated
01/26/2021
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