Basic Information
Provider Information
NPI: 1750416855
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TAIGEN
FirstName: TYLER
MiddleName: L.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 95 ARCH ST
Address2:  
City: AKRON
State: OH
PostalCode: 443041437
CountryCode: US
TelephoneNumber: 3303767000
FaxNumber: 3303761066
Practice Location
Address1: 95 ARCH ST
Address2:  
City: AKRON
State: OH
PostalCode: 443041437
CountryCode: US
TelephoneNumber: 3303767000
FaxNumber: 3303761066
Other Information
ProviderEnumerationDate: 02/22/2007
LastUpdateDate: 07/03/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0001X35099022OHY Allopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology

No ID Information.


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