Provider Demographics
NPI:1396924270
Name:RAILE, TYLER M (PA)
Entity type:Individual
Prefix:MR
First Name:TYLER
Middle Name:M
Last Name:RAILE
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:PO BOX 1075
Mailing Address - Street 2:221 W FIRST
Mailing Address - City:SAINT FRANCIS
Mailing Address - State:KS
Mailing Address - Zip Code:67756-1075
Mailing Address - Country:US
Mailing Address - Phone:785-332-2682
Mailing Address - Fax:785-332-2516
Practice Address - Street 1:221 WEST FIRST
Practice Address - Street 2:
Practice Address - City:SAINT FRANCIS
Practice Address - State:KS
Practice Address - Zip Code:67756-1075
Practice Address - Country:US
Practice Address - Phone:785-332-2682
Practice Address - Fax:785-332-2516
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS15-01199363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200532200AMedicaid
KS427228OtherBCBS