Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 36930 | SC |
N | 208600000X | Surgeon | 36930 | SC |
N | 208200000X | Surgeon | 38326 | AL |
N | 208600000X | Surgeon | 38326 | AL |
N | 2086S0102X | Surgical Critical Care | 38326 | AL |
Y | 2086S0127X | Trauma Surgeon | 38326 | AL |
NPI | 1174937528 |
---|---|
Provider Name | Dr. Kevin Tyler |
First Address | Huntsville, AL 35804-2705 |
Second Address | Huntsville, AL 35801-5177 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2014 |
Last Update Date | 20/09/2021 |