Tyler Mark Nixon DO, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20A13158 Issued in CA

Legal business name

TYLER MARK NIXON DO, INC

Practice address

1250 Broadway
Sonoma, CA 95476-7500

Phone

(707) 938-8406

NPI assigned

Jul 7, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tyler Mark Nixon, DO

Title

President

Phone

(253) 212-7129

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1437532652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 CALISTOGA RD",
            "address_2": "SUITE 361",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954093702",
            "telephone_number": "253-212-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 BROADWAY",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954767500",
            "telephone_number": "707-938-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER MARK NIXON DO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "NIXON",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-212-7129",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A13158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Sonoma, CA
• Providers in Sonoma, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.