| Tyler Mark Nixon Do, Inc | |
|
1250 Broadway Sonoma CA 95476-7500 | |
| (707) 938-8406 | |
| Not Available |
| Full Name | Tyler Mark Nixon Do, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1250 Broadway, Sonoma, California |
| Authorized Official Name and Position | Tyler Mark Nixon (PRESIDENT) |
| Authorized Official Contact | 2532127129 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tyler Mark Nixon Do, Inc 122 Calistoga Rd Suite 361 Santa Rosa CA 95409-3702 Ph: (253) 212-7129 | Tyler Mark Nixon Do, Inc 1250 Broadway Sonoma CA 95476-7500 Ph: (707) 938-8406 |
| NPI Number | 1437532652 |
|---|---|
| Provider Enumeration Date | 07/07/2015 |
| Last Update Date | 07/16/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437532652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 20A13158 (California) | Primary |
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