Tyson Family Medical P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS005343-L Issued in PA

Legal business name

TYSON FAMILY MEDICAL P.C.

Practice address

2831 Tyson Ave
Philadelphia, PA 19149-1415

Phone

(267) 350-5575

Fax

(215) 624-0874

NPI assigned

Jul 15, 2006

Last updated

Nov 12, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David M Pudles, D.ONPI 1548208770

Title

Owner

Phone

(267) 350-5575

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David M Pudles, D.O.

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1548208770
  Authorized official Same address or phone

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194825600000",
    "number": "1740206226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 TYSON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191491415",
            "telephone_number": "267-350-5575",
            "fax_number": "215-624-0874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 TYSON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191491415",
            "telephone_number": "267-350-5575",
            "fax_number": "215-624-0874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYSON FAMILY MEDICAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-11-12",
        "status": "A",
        "authorized_official_last_name": "PUDLES",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-350-5575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS005343-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oluwatumininu Conrad Tyndall
• Nicholas Tyner, MD
• Jasmin Jetie Tyree, MHS-C , LBS
• Kareem Delmar Tyree, M.ED
• Erin O'Malley Tysko, MD
• Tyson Foot Care, PC
• Andrew David Tyson, PA-C
• Charles Germaine Tyson, LCSW, BCD
• Demare Tyson
• Jordan Tzabari, MD

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; 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.