Healthcare Provider Details

I. General information

NPI: 1316501323
Provider Name (Legal Business Name): TYLER CALKINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2019
Last Update Date: 08/13/2025
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 N MASON RD DEPT ORTHOPAEDIC SURGERY, STE 110/210
SAINT LOUIS MO
63141-6431
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 314-514-3500
  • Fax: 314-878-7678
Mailing address:
  • Phone: 314-514-3500
  • Fax: 314-878-7678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number2025024063
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: