Fanning, Tyler

Fanning, Tyler is an sole proprietor health care provider with primary practice located at 1112 Nw Circle Blvd , Corvallis OR 97330-1462. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Fanning, Tyler can be contacted via phone (541) 768-5235.

Contact Information

Primary practice address
1112 Nw Circle Blvd Corvallis OR 97330-1462
Phone: (541) 768-5235
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD216942 Oregon
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 042.0014873 Vermont
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1760987473
LBN Legal business name Fanning, Tyler
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 26th, 2018
Last updated Sep 19th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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