Healthcare Provider Details

I. General information

NPI: 1235061532
Provider Name (Legal Business Name): TYLER TURNBULL PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

776 TRIANGLE ST
BLACKSBURG VA
24060-7750
US

IV. Provider business mailing address

1413 MURPHY DR
JOHNSTOWN PA
15905-1530
US

V. Phone/Fax

Practice location:
  • Phone: 814-525-9554
  • Fax:
Mailing address:
  • Phone: 814-525-9554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: