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Contact Information

TYLER J RUNDELL, PA-C
585 MAIN ST
GREEN RIVER, UT84525
 Phone: 435-564-3434
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for TYLER J RUNDELL · (Male)

NPI Number 1861962912
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 12/03/2018
Last updated 12/03/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • UT License # 10877596-8906
  • Other 1152696 NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS
  • UT Other 10877596-1206 UTAH DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING
  • UT Other 10877596-8906 UTAH DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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