Individual
TYLER LENNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-2000
Mailing address
621 N 70TH ST, WAUWATOSA, WI 53213-3853
(920) 562-4922
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036.155530
IL
208000000X
Pediatrics Physician
Primary
83855-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831695899
NPI
—
Enumeration date
03/30/2018
Last updated
04/25/2024
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