Individual
TYLER JORDAN ISRAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 BRECKENRIDGE ST, OWENSBORO, KY 42303-1089
(270) 683-8672
(270) 685-8233
Mailing address
13120 SW 92ND AVE PH 19, MIAMI, FL 33176-8707
(270) 313-7347
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TC200
KY
Other
Enumeration date
03/07/2019
Last updated
06/20/2022
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