Provider Demographics
NPI:1275753717
Name:TYLER, KIM N (MD)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:N
Last Name:TYLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7111 E LOWRY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7360
Mailing Address - Country:US
Mailing Address - Phone:303-394-2828
Mailing Address - Fax:303-320-0242
Practice Address - Street 1:7111 E LOWRY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7360
Practice Address - Country:US
Practice Address - Phone:303-394-2828
Practice Address - Fax:303-320-0242
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0046827207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO566552ZZFYOtherMEDICARE
CO35730358Medicaid
TX190026801Medicaid