Provider Demographics
NPI:1336357284
Name:HALL, TYLER ANDREW (MD)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:ANDREW
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 59449
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35259-9449
Mailing Address - Country:US
Mailing Address - Phone:205-876-8988
Mailing Address - Fax:205-390-6460
Practice Address - Street 1:1720 UNIVERSITY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1816
Practice Address - Country:US
Practice Address - Phone:833-733-8747
Practice Address - Fax:205-390-6460
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL27565207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102I189509OtherMEDICARE PTAN
AL117449Medicaid
AL51120733OtherBLUE CROSS AND BLUE SHIELD OF ALABAMA
ALP01052154OtherRAILROAD MEDICARE PTAN