Provider Demographics
NPI:1063830909
Name:JANZ, TYLER (MD)
Entity type:Individual
Prefix:MR
First Name:TYLER
Middle Name:
Last Name:JANZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8035 PROVIDENCE RD STE 320
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-8910
Mailing Address - Country:US
Mailing Address - Phone:704-752-7575
Mailing Address - Fax:
Practice Address - Street 1:8035 PROVIDENCE RD STE 320
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-8910
Practice Address - Country:US
Practice Address - Phone:704-752-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-28
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRPT52548183700000X
SC95192207Y00000X
TXBP10066742207Y00000X
NC2025-02144207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No183700000XPharmacy Service ProvidersPharmacy Technician