Individual
TYLER WILLIAMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
580 E 9400 S, 103, SANDY, UT 84070-8407
(225) 939-8180
Mailing address
580 E 9400 S # 103, SANDY, UT 84070-6237
(225) 939-8180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9066323-1206
DIVISION OF PROFESSIONAL LICENSING
UT
Enumeration date
06/09/2014
Last updated
03/05/2024
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