Provider Demographics
NPI:1215133830
Name:TYLER, JOSHUA A (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:A
Last Name:TYLER
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 1:147 REYNOIR ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39530-4121
Mailing Address - Country:US
Mailing Address - Phone:228-436-1273
Mailing Address - Fax:228-435-3211
Practice Address - Street 1:147 REYNOIR ST STE 200
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-4121
Practice Address - Country:US
Practice Address - Phone:228-436-1273
Practice Address - Fax:228-435-3211
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS23520208600000X
NE24834208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery