Individual
CHARLES BRENT TYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
204 N WESTOVER BLVD, ALBANY, GA 31707-2983
(229) 888-6559
(229) 436-4107
Mailing address
204 N WESTOVER BLVD, ALBANY, GA 31707-2983
(229) 888-6559
(229) 436-4107
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
041234
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00692612B
—
GA
Enumeration date
09/21/2005
Last updated
10/12/2011
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