Provider Demographics
NPI:1710008297
Name:BECKLEY, TYLER JOEL (DO)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:JOEL
Last Name:BECKLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 HOSPITAL LN STE 300
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46122-2000
Mailing Address - Country:US
Mailing Address - Phone:317-718-4676
Mailing Address - Fax:317-718-2476
Practice Address - Street 1:100 HOSPITAL LN STE 300
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-2000
Practice Address - Country:US
Practice Address - Phone:317-718-4676
Practice Address - Fax:317-718-2476
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02005170A207X00000X
MI5101016608207X00000X
WI54007207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery