Mauldin, Ty

Mauldin, Ty is an individual health care provider with primary practice located at 1316 W Wicklow Ct , Sioux Falls SD 57108-3252. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Student, Health Care / Student in an Organized Health Care Education/Training Program. Student, Health Care / Student in an Organized Health Care Education/Training Program is his primary health care specialty. Mauldin, Ty can be contacted via phone (605) 836-1227.

Contact Information

Primary practice address
1316 W Wicklow Ct Sioux Falls SD 57108-3252
Phone: (605) 836-1227
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X GC05112013 South Dakota
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X Florida

Profile Details

NPI number 1134880453
LBN Legal business name Mauldin, Ty
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2022
Last updated Aug 18th, 2022 - about 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1134880453 NPPES
Tennessee Other 5020425893002 SS NETWORK ALLIANCE #
Tennessee Other 96440 SS NETWORK ALLIANCE #
Tennessee Other TAMGC05152013 SS NETWORK ALLIANCE #

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