Individual
MR. TYLER ABRAHAM DE WITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
120 HELMWOOD PLAZA DR STE 103, ELIZABETHTOWN, KY 42701-3459
(270) 979-7171
(270) 979-7172
Mailing address
401 E CHESTNUT ST UNIT 600, LOUISVILLE, KY 40202-5705
(502) 588-4450
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
56091
KY
2084P0800X
Psychiatry Physician
R4691
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
KY
Other
Enumeration date
04/06/2017
Last updated
09/20/2022
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