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Individual

TYLER CROSSLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
560 W 465 N STE 604, PROVIDENCE, UT 84332-8006
(435) 753-1600
(435) 753-9521
Mailing address
560 W 465 N STE 604, PROVIDENCE, UT 84332-8006
(435) 753-1600
(435) 753-9521

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
13166124-1204
UT
207L00000X
Anesthesiology Physician
Primary
94-09936
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1821658014
UT
Enumeration date
06/19/2019
Last updated
06/17/2026
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