Witt, Ty Robert

Witt, Ty Robert is an individual health care provider with primary practice located at 19610 N 68Th Ave , Glendale AZ 85308-5515. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Witt, Ty Robert can be contacted via phone (623) 215-6532.

Contact Information

Primary practice address
19610 N 68Th Ave Glendale AZ 85308-5515
Phone: (623) 215-6532
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 30147 Arizona
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X MD00038457 Washington

Profile Details

NPI number 1467444828
LBN Legal business name Witt, Ty Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2005
Last updated Jun 15th, 2011 - about 15 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 1467444828 NPPES
Washington MEDICAID 1020730

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