Provider Demographics
NPI:1134120272
Name:TYLER, DONALD R (M D)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:R
Last Name:TYLER
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3280 DAUPHIN ST
Mailing Address - Street 2:BUILDING A
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-4060
Mailing Address - Country:US
Mailing Address - Phone:251-450-3700
Mailing Address - Fax:251-662-3819
Practice Address - Street 1:3280 DAUPHIN ST
Practice Address - Street 2:BUILDING A
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-4060
Practice Address - Country:US
Practice Address - Phone:251-450-3700
Practice Address - Fax:251-662-3819
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL24665207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051503556Medicare ID - Type Unspecified
ALH01658Medicare UPIN