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Dr. Tyler Guthrie Johnson, DO
Student in an Organized Health Care Education/Training Program in Fort Wayne, Indiana
NPI 1578798757

Tyler Guthrie Johnson is a Student in an Organized Health Care Education/Training Program based in Fort Wayne, IN. Tyler Guthrie Johnson practices in Fort Wayne, IN and has the professional credentials of DO. The NPI Number for Tyler Guthrie Johnson is 1578798757 and holds a License No. 5101018131 (Indiana).

The current practice location address for Tyler Guthrie Johnson is 2200 Randallia Dr, Fort Wayne, IN and can be reached out via phone at 260-373-4000 and via fax at 260-482-4442. You can also correspond with Tyler Guthrie Johnson through the mailing address at 3640 NEW VISION DR, FORT WAYNE, IN - 46845-1717 (mailing address contact number: 260-482-4440).

Location: 2200 Randallia Dr, Fort Wayne, IN, 46845-1717
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1578798757
Provider Name
Tyler Guthrie Johnson
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
2200 Randallia Dr, Fort Wayne, IN, 46845-1717
Phone Number
260-373-4000
Fax Number
260-482-4442
Provider Enumeration Date
05/18/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
M400058749 01 IN MEDICARE WPS CMS
201040270 05 IN
institution
Provider Business Practice Location Address Details
Address
2200 Randallia Dr
City
Fort Wayne
State
Indiana
Zip
46805-4638
Phone Number
260-373-4000
Fax Number
260-482-4442
person
Provider Business Mailing Address Details
Address
3640 New Vision Dr
City
Fort Wayne
State
Indiana
Zip
46845-1717
Phone Number
260-482-4440
Fax Number
260-482-4442
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Emergency Medicine
Speciality
-
Taxonomy
207P00000X
License No.
02003913A (Indiana)
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
5101018131 (Michigan)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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