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Individual

TYLER CHURCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
428 S GILBERT RD STE 115, GILBERT, AZ 85296-2262
(480) 507-2961
(480) 507-2971
Mailing address
PO BOX 1847, GILBERT, AZ 85299-1847
(480) 507-2961
(480) 507-2971

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
374433-1205
UT
207L00000X
Anesthesiology Physician
Primary
37949
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
350318
AZ
Enumeration date
12/17/2007
Last updated
03/07/2023
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