Provider Demographics
NPI:1386611697
Name:HAMMELL, TYLER JOE (DC)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:JOE
Last Name:HAMMELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHAMBERLAIN
Mailing Address - State:SD
Mailing Address - Zip Code:57325
Mailing Address - Country:US
Mailing Address - Phone:605-234-6968
Mailing Address - Fax:
Practice Address - Street 1:303 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CHAMBERLAIN
Practice Address - State:SD
Practice Address - Zip Code:57325
Practice Address - Country:US
Practice Address - Phone:605-234-6968
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD778111N00000X
WI0002927012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD22022OtherSIOUX VALLEY HEALTH PLAN
SD0003104OtherBLUE CROSS BLUE SHIELD
SD0003104OtherBLUE CROSS BLUE SHIELD
U37575Medicare UPIN