Tyler Hooton, MD
Student in an Organized Health Care Education/Training Program in Saint Louis, MO. Individual provider (NPI-1).
NPI number1841828811
StatusActive
Last updated in NPPESJan 20, 2024
Details
- NPI
- 1841828811
- Entity type
- Individual (NPI-1)
- Name
- Tyler Hooton
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 27, 2020
- Certification date
- Jan 20, 2024
- Last updated
- Jan 20, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
| 207N00000X | Dermatology | 2023047873 | MO |
Practice location
1008 S Spring AveSaint Louis, MO 63110-2520
Phone 314-977-3400
Mailing address
1008 S Spring AveSaint Louis, MO 63110-2520
Phone 208-821-1141
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