Provider Demographics
NPI:1427008184
Name:KIRBY, TYLER O'NEAL (MD)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:O'NEAL
Last Name:KIRBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2705
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804-2705
Mailing Address - Country:US
Mailing Address - Phone:256-801-6048
Mailing Address - Fax:256-801-6218
Practice Address - Street 1:201 SIVLEY RD SW
Practice Address - Street 2:SUITE 620
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5134
Practice Address - Country:US
Practice Address - Phone:256-265-4600
Practice Address - Fax:256-265-4651
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95793207VX0201X
ALMD.23784207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051530398OtherBLUE CROSS
AL009969155Medicaid
ALP01335306OtherRAILROAD PTAN
AL051514743OtherBLUE CROSS
AL155957Medicaid
AL009923185Medicaid
AL511-44257OtherBLUE CROSS
AL051514740OtherBLUE CROSS
AL051514741OtherBLUE CROSS
AL051523912OtherBLUE CROSS
AL009923175Medicaid
ALP00008044OtherRAILROAD MEDICARE
AL051514740Medicaid
AL102I986140OtherMEDICARE PTAN
AL009923165Medicaid
AL051514742OtherBLUE CROSS