Individual
TYLER CARRY WARMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 S MADISON ST, APPLETON, WI 54915-1846
(920) 738-2000
Mailing address
2108 MARKHAM DR, CHAPEL HILL, NC 27514-2123
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
83204
WI
390200000X
Student in an Organized Health Care Education/Training Program
239436
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100280513
—
WI
Enumeration date
05/01/2018
Last updated
07/15/2024
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