Individual
DR. TYLER B. VINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-4581
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
009036
GA
Other
Enumeration date
06/05/2017
Last updated
06/05/2017
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