Basic Information
| Provider Information | |||||||||
| NPI: | 1194085803 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRIERLEY | ||||||||
| FirstName: | TYSON | ||||||||
| MiddleName: | DON | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 750 WARNER DR | ||||||||
| Address2: | |||||||||
| City: | GOLDEN | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804015297 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039254340 | ||||||||
| FaxNumber: | 3039254341 | ||||||||
| Practice Location | |||||||||
| Address1: | 40 ARCH ST | ||||||||
| Address2: | |||||||||
| City: | JOHNSON CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 137902102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077636075 | ||||||||
| FaxNumber: | 6077635234 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2012 | ||||||||
| LastUpdateDate: | 04/03/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | DR.0055450 | CO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.