Provider Demographics
NPI:1376427484
Name:PHILLIPS, TYLER DEAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:DEAN
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14572 N SAGINAW RD APT 2
Mailing Address - Street 2:
Mailing Address - City:CLIO
Mailing Address - State:MI
Mailing Address - Zip Code:48420-8823
Mailing Address - Country:US
Mailing Address - Phone:810-618-2547
Mailing Address - Fax:
Practice Address - Street 1:8021 MILLER RD
Practice Address - Street 2:
Practice Address - City:SWARTZ CREEK
Practice Address - State:MI
Practice Address - Zip Code:48473-1342
Practice Address - Country:US
Practice Address - Phone:810-635-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302417776183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist