Provider Demographics
NPI:1285779991
Name:GARNER, JOHN TYLER (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:TYLER
Last Name:GARNER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 HIGHWAY 53
Mailing Address - Street 2:
Mailing Address - City:EVELETH
Mailing Address - State:MN
Mailing Address - Zip Code:55734-8523
Mailing Address - Country:US
Mailing Address - Phone:218-744-1961
Mailing Address - Fax:218-744-1961
Practice Address - Street 1:2302 HIGHWAY 53
Practice Address - Street 2:
Practice Address - City:EVELETH
Practice Address - State:MN
Practice Address - Zip Code:55734-8523
Practice Address - Country:US
Practice Address - Phone:218-744-1961
Practice Address - Fax:218-744-1961
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN774213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist