Individual
JAMES M TYTKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2145 N FAIRFIELD RD STE 100, BEAVERCREEK, OH 45431-2783
(937) 558-3900
(937) 558-3999
Mailing address
2145 N FAIRFIELD RD STE 100, BEAVERCREEK, OH 45431-2783
(937) 558-3900
(937) 558-3999
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35046245
OH
207QS0010X
Sports Medicine (Family Medicine) Physician
35046245
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0511986
—
OH
01
—
080152126
MEDICARE RR
OH
Enumeration date
08/23/2005
Last updated
11/17/2020
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