Healthcare Provider Details

I. General information

NPI: 1215133830
Provider Name (Legal Business Name): JOSHUA A TYLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 REYNOIR ST STE 200
BILOXI MS
39530-4121
US

IV. Provider business mailing address

147 REYNOIR ST STE 200
BILOXI MS
39530-4121
US

V. Phone/Fax

Practice location:
  • Phone: 228-436-1273
  • Fax: 228-435-3211
Mailing address:
  • Phone: 228-436-1273
  • Fax: 228-435-3211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number23520
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number24834
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: