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Individual

TYLER LYLE WARNECKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
7910 W JEFFERSON BLVD STE 120, FORT WAYNE, IN 46804-4159
(260) 435-7612
(260) 479-4618
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3514
(260) 479-3520

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001793A
IN

Other

Enumeration date
08/28/2013
Last updated
09/30/2020
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