Individual
TYLAN WAYNE MAGNUSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
NP 2540, 1720 2ND AVENUE SOUTH, BIRMINGHAM, AL 35294-3300
(205) 933-8101
(205) 934-9573
Mailing address
625 19TH ST SOUTH, BIRMINGHAM, AL 35249-1900
(205) 934-2490
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
41817
AL
Other
Enumeration date
03/23/2019
Last updated
08/21/2023
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