Healthcare Provider Details

I. General information

NPI: 1629573506
Provider Name (Legal Business Name): TYLER CULPEPPER MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2018
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1248 HUFFMAN MILL RD STE 201
BURLINGTON NC
27215-8700
US

IV. Provider business mailing address

PO BOX 100277
GAINESVILLE FL
32610-0277
US

V. Phone/Fax

Practice location:
  • Phone: 336-586-4002
  • Fax: 336-586-4002
Mailing address:
  • Phone: 352-265-0655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME149625
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number2022-00602
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: