Roe, Tyler

Roe, Tyler is an individual health care provider with primary practice located at 1344 Hiland Ave Ste A , Burley ID 83318. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Roe, Tyler can be contacted via phone (208) 678-7246.

Contact Information

Primary practice address
1344 Hiland Ave Ste A Burley ID 83318
Phone: (208) 678-7246
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X Q8621 Texas
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X O-1201 Idaho

Profile Details

NPI number 1710305768
LBN Legal business name Roe, Tyler
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2014
Last updated Apr 13th, 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 1710305768 NPPES
Texas MEDICAID 388203701
Texas Other 388203702

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