TYLER J HARRIS


Address: 190 E Bannock St, Boise, ID 83712-6241
Phone: 2083812094

TYLER J HARRIS (NPI# 1275794935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1275794935
Entity Type Individual
Full Name TYLER J HARRIS
Credential MD
Practice Address 190 E Bannock St
Boise
ID 83712-6241
Mailing Address Po Box 1108
Corvallis
OR 97339-1108
Practice Telephone 2083812094
Practice Fax Number 2083811791
Mailing Telephone 2083812094
Mailing Fax Number 2083811791
Enumeration Date 2008-06-24
Last Update Date 2018-01-10
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0202X Radiology
Specialization: Diagnostic Radiology
M12086 ID Allopathic & Osteopathic Physicians
N 2085R0202X Radiology
Specialization: Diagnostic Radiology
A119515 CA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CA 0A1195150 05

Other Providers TYLER HARRIS

NPI Name Taxonomy Address Enumeration
1982233441 Tyler Harris Student in an Organized Health Care Education/Training Program 13001 East 17 Th Place, Aurora, CO 80045-2581 2020-04-06
1669865754 Tyler Harris Specialist/Technologist 1401 Presque Isle Ave Apt 111, Marquette, MI 49855-2818 2015-03-12
1164839510 Tyler Harris Pharmacist 11880 28th St N Ste 100, St Petersburg, FL 33716-1824 2014-07-17
1962799460 Tyler James Harris Emergency Medicine 1510 12th Ave Rd Ste 100, Nampa, ID 83686 2011-07-05
1265439103 Tyler Elliott Harris Orthopaedic Surgery 1201 Alhambra Blvd, Sacramento, CA 95816-5243 2005-07-07
1104448869 Tyler Harris Behavior Technician 4105 N Walnut St, Muncie, IN 47303-5904 2020-05-15
1073167524 Tyler Harris Physical Therapy Assistant 20270 E Smoky Hill Rd, Centennial, CO 80015 2019-08-01
1073003646 Tyler Duane Harris Student in an Organized Health Care Education/Training Program 1200 Childrens Ave, Oklahoma City, OK 73104 2018-05-18
1700129004 Tyler Van Harris Counselor 2655 Ashmun St, Sault Sainte Marie, MI 49783-3711 2013-04-04
1043535826 Tyler Hutchison Harris Pediatrics 4401 Penn Ave, Pediatric Cardiology - Third Floor, Pittsburgh, PA 15224-1334 2010-04-05

Office Location

Street Address 190 E BANNOCK ST
City BOISE
State ID
Zip Code 83712-6241

Providers in the same location

NPI Name Taxonomy Address Enumeration
1770586794 St Lukes Regional Medical Center Pharmacy 190 E Bannock St, Boise, ID 83712-6241 2005-05-23
1275133944 St Lukes Health System Ltd General Acute Care Hospital 190 E Bannock St, Boise, ID 83712-6241 2020-10-30
1750980017 Andrea Johnson Murray Pharmacy Technician 190 E Bannock St, Boise, ID 83712-6241 2020-10-19
1679180103 Katie Marie Pond Social Worker 190 E Bannock St, Boise, ID 83712-6241 2020-09-29
1780297762 Alexandria Marie Schultz Pharmacist 190 E Bannock St, Boise, ID 83712-6241 2020-08-28
1225640048 Tania Michelle Villanueva-sanchez Pharmacist 190 E Bannock St, Boise, ID 83712-6241 2020-08-21
1154931426 Brittany Nichole Galop Pharmacist 190 E Bannock St, Boise, ID 83712-6241 2020-08-03
1558970046 Emily Michelle Bush Pharmacist 190 E Bannock St, Boise, ID 83712-6241 2020-07-30
1699393447 Chadd Miller Ramos Pharmacist 190 E Bannock St, Boise, ID 83712-6241 2020-07-08
1740819127 Lindzee Searle Pharmacy Technician 190 E Bannock St, Boise, ID 83712-6241 2020-04-07
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477016012 Veranda At Barber Station LLC Assisted Living Facility 3266 E. Barber Valley Drive, Boise, ID 83712 2019-04-10
1891258612 Mary Elizabeth Riedel Occupational Therapist 190 E Bancock St., Boise, ID 83712 2019-04-09
1427523968 Q17 Health Partners LLC Surgery 100 East Idaho Street #317, Boise, ID 83712 2018-10-11
1053898247 Travis Dale Worwood Social Worker South Entrance, 1075 E. Park Blvd, Boise, ID 83712 2018-07-20
1689166761 Kristen Nicole Ray Social Worker 109 E Bannock St, Boise, ID 83712 2018-06-04
1740706894 Meghan Heitstuman Social Worker 190 E Bannock Street, Boise, ID 83712 2017-08-21
1942759725 Kay Craig Physical Therapist 190 Bannock, Boise, ID 83712 2016-09-22
1235686395 Sharon Bjornson Physical Therapist 190 East Bannack, Boise, ID 83712 2016-09-07
1033576491 Heather Hussey Genetic Counselor, MS 100 E Idaho Street, Msti Genetics, Boise, ID 83712 2016-01-15
1295139137 Amie Bartholomeus Massage Therapist 100 East Idaho Street, St Luke's Mountain States Tumor Institute, Boise, ID 83712 2014-10-21
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Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1376920553 Creighton Lewis Radiology 500 West Fort St. #111r, Boise Vamc, Boise, ID 83702 2015-04-27
1295926061 Michael Modica Radiology 877 W Main St, Suite 603, Boise, ID 83702-5883 2007-08-07
1346457298 John Charles Kirkham Radiology 115 W Main St Ste 202, Boise, ID 83702-7303 2007-05-17
1811046386 Frank J Daniels Radiology 5122 S Surprise Way Apt 202, Boise, ID 83716-9050 2007-01-10
1821039025 Michael J Ryan Radiology 232 S Whisperwood Way, Boise, ID 83709-4900 2006-06-09
1679513303 Intermountain Medical Imaging LLC Radiology 161 E Mallard Dr, Suite 120, Boise, ID 83706-5015 2006-06-08
1669423679 Intermountain Medical Imaging LLC Radiology 927 W Myrtle St, Boise, ID 83702-7061 2006-05-15
1174589543 Laura M Wike Radiology 2517 N Cisco Ln, Boise, ID 83702-5502 2006-04-25
1922077635 Ryan Slaughter Radiology 907 Harrison Blvd, Boise, ID 83702-4052 2006-03-15
1336554740 Geoffry De Gennaro Jr. Radiology 190 E Bannock St, Boise, ID 83712-6241 2014-06-24
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Competitor

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City BOISE
Zip Code 83712

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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