Individual
DR. TYLER GEORGE GASSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2094
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2094
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
155432
CA
2085R0202X
Diagnostic Radiology Physician
49037
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427202373
—
ID
Enumeration date
11/05/2008
Last updated
09/19/2024
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