Individual
TYLER ANTHONY PTACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
6652
NE
207Q00000X
Family Medicine Physician
7731
KS
208VP0014X
Interventional Pain Medicine Physician
Primary
12138
SD
208VP0014X
Interventional Pain Medicine Physician
2016019592
MO
Other
Enumeration date
06/23/2011
Last updated
04/04/2026
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