MEDICARE: J TYLER MARTIN MD

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	207RI0200X	Infectious Disease Physician	17566	NE
2	2080P0208X	Pediatric Infectious Diseases Physician	17566	NE

General Provider Information

NPI Number	:	1649153594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	J TYLER MARTIN MD

Provider Business Mailing Address
First Line	:	5200 QUARRY LEDGE RD
Second Line	:
City	:	ROCA
State	:	NE
Zip	:	68430-4284
Country	:	US
Telephone Number	:	402-587-2312
Fax Number	:

Provider Business Practice Location Address
First Line	:	5200 QUARRY LEDGE RD
Second Line	:
City	:	ROCA
State	:	NE
Zip	:	68430-4284
Country	:	US
Telephone Number	:	402-587-2312
Fax Number	:

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

Provider Enumeration Date	:	07/29/2025
Last Update Date	:	07/29/2025

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Directions to “ J TYLER MARTIN MD” Practice Location

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