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Individual

TYLER TANTISOOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2525 DESALES AVE, CHATTANOOGA, TN 37404-1161
(423) 697-0014
(423) 648-6280
Mailing address
725 GLENWOOD DR STE E487, CHATTANOOGA, TN 37404-1173
(423) 697-0014
(423) 648-6280

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
63587
TN
207P00000X
Emergency Medicine Physician
86971
GA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/11/2018
Last updated
08/30/2021
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