Individual
DR. TYLER GREGORY ELLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
10512 N 110TH EAST AVE, OWASSO, OK 74055-6636
(918) 592-0999
Mailing address
9228 S MINGO RD STE 200, TULSA, OK 74133-5722
(918) 592-0999
(918) 592-1021
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
6866
OK
390200000X
Student in an Organized Health Care Education/Training Program
BP10049312
TX
Other
Enumeration date
04/18/2014
Last updated
08/01/2020
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