Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Tyler Johnson Rodriguez

Individual provider Physician Assistant · NPI 1063248201

Mr. Tyler Johnson Rodriguez is a Physician Assistant in Atlanta, Georgia. Licensed in Georgia. Registered with an NPI since 2024.

Licensed in
GA
In the registry since
2024

Practice location Address checks out

4480 N Shallowford Rd Ste 200
Atlanta, GA 30338-6410
Phone: (336) 653-9493
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 12613 (GA)

Record details

NPI number1063248201
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 13, 2024
Last updated in NPPESJanuary 6, 2026
Certification dateJanuary 6, 2026
Mailing address982 Memorial Dr Se Apt 516, Atlanta, GA 30316-4474

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