Individual
TYLER J GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10800 E GEDDES AVE STE 300, ENGLEWOOD, CO 80112-3895
(303) 761-9190
(720) 874-4462
Mailing address
10800 E GEDDES AVE STE 300, ENGLEWOOD, CO 80112-3895
(303) 761-9190
(720) 874-4462
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
04-40433
KS
2085R0202X
Diagnostic Radiology Physician
30330
NE
2085R0202X
Diagnostic Radiology Physician
55471
CO
2085R0202X
Diagnostic Radiology Physician
MD166193
OR
2085R0202X
Diagnostic Radiology Physician
MD19335
HI
2085R0204X
Vascular & Interventional Radiology Physician
Primary
DR.0055471
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111257111
MEDICARE PIN
KS
05
—
1780849620
—
CO
01
—
590453YQ33
MEDICARE PIN
CO
01
—
590453YQ3L
MEDICARE PIN
CO
01
—
590453YQN9
MEDICARE PIN
CO
01
—
590453YQPG
MEDICARE PIN
CO
01
—
KA3249102
MEDICARE PIN
KS
01
—
NA1214123
MEDICARE PIN
NE
01
—
NA1215124
MEDICARE PIN
NE
01
—
NA2517101
MEDICARE PIN
NE
Enumeration date
07/21/2008
Last updated
11/17/2023
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