Provider Demographics
NPI:1558320408
Name:TIGYER, LANCE M (D O)
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:M
Last Name:TIGYER
Suffix:
Gender:M
Credentials:D O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7980 N. MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-2328
Mailing Address - Country:US
Mailing Address - Phone:937-280-4988
Mailing Address - Fax:937-280-4994
Practice Address - Street 1:7980 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-2328
Practice Address - Country:US
Practice Address - Phone:937-280-4988
Practice Address - Fax:937-280-4994
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.008657207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2673049Medicaid
OHP00871997OtherRR MEDICARE
OH2673049Medicaid
OH4184391Medicare PIN