Individual
TYLER ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MHA
Contact information
Practice address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
(801) 373-0639
Mailing address
501 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1222
(801) 581-7951
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
DR.0059856
CO
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
6219794-1205
UT
Other
Enumeration date
05/11/2011
Last updated
06/04/2021
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