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Individual

MRS. MARY ALLISON ROENSCH TYLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2377 LENORA CHURCH RD, SNELLVILLE, GA 30078-3232
(770) 979-2020
(770) 978-3321
Mailing address
2377 LENORA CHURCH RD, SNELLVILLE, GA 30078-3232
(770) 979-2020
(770) 978-3321

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
066312
GA
207W00000X
Ophthalmology Physician
Primary
66312
GA
207W00000X
Ophthalmology Physician
BP10031491
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003113439A
GA
Enumeration date
05/01/2008
Last updated
11/03/2016
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