Healthcare Provider Details

I. General information

NPI: 1164699351
Provider Name (Legal Business Name): TYLER BACHMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2008
Last Update Date: 08/25/2020
Certification Date: 08/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 E 51ST ST SUITE A
TULSA OK
74135-3627
US

IV. Provider business mailing address

1916 RICHMOND DR
BARTLESVILLE OK
74006-6907
US

V. Phone/Fax

Practice location:
  • Phone: 918-747-0939
  • Fax: 918-747-3939
Mailing address:
  • Phone: 918-231-7832
  • Fax: 918-747-3939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3877
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: