MEDICARE: DR. ALEX TYLER SOMERVILLE DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	34.018454	OH

General Provider Information

NPI Number	:	1003511510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEX TYLER SOMERVILLE DO

Provider Business Mailing Address
First Line	:	90 JACKSON PIKE
Second Line	:
City	:	GALLIPOLIS
State	:	OH
Zip	:	45631-1562
Country	:	US
Telephone Number	:	740-446-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2605 JACKSON AVE
Second Line	:
City	:	POINT PLEASANT
State	:	WV
Zip	:	25550-1698
Country	:	US
Telephone Number	:	855-446-5937
Fax Number	:	304-675-4498

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2023
Last Update Date	:	05/21/2026

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