Basic Information
| Provider Information | |||||||||
| NPI: | 1437391984 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MARTINEZ | ||||||||
| FirstName: | TYLER | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 W MINNEZONA AVE | ||||||||
| Address2: | APT 1023 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850134933 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4803261812 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10401 W THUNDERBIRD BLVD | ||||||||
| Address2: | EMERGENCY DEPT | ||||||||
| City: | SUN CITY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853513004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6238324000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2009 | ||||||||
| LastUpdateDate: | 05/12/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 006067 | AZ | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.