Individual
TIMOTHY LAWRENCE TYTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4625 S WESTERN AVE, OKLAHOMA CITY, OK 73109-3831
(405) 632-2323
(405) 631-9315
Mailing address
PO BOX 95818, OKLAHOMA CITY, OK 73143-5818
(405) 632-2323
(405) 631-9315
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
11480
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100213590B
—
OK
Enumeration date
05/03/2006
Last updated
03/24/2008
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