Individual
MR. TYLER WILSON CLEMMENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
625 19TH ST S, BIRMINGHAM, AL 35249
(205) 934-4303
(205) 934-5499
Mailing address
625 19TH ST S, BIRMINGHAM, AL 35249
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
35415
AL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
35415
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2014
Last updated
05/01/2019
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