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1710572763

NPI Code Detail

MEDICARE: TYLER KING MD

MEDICARE: TYLER KING 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	208D00000X	General Practice Physician	01088186A	IN
2	2083A0100X	Aerospace Medicine Physician	01088186A	IN
3	171000000X	Military Health Care Provider	01088186A	IN

General Provider Information

NPI Number	:	1710572763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYLER KING MD

Provider Business Mailing Address
First Line	:	1817 SPENCER AVE
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28560-5423
Country	:	US
Telephone Number	:	252-466-0921
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 N 12TH ST STE 605
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2850
Country	:	US
Telephone Number	:	602-839-4567
Fax Number	:

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

Provider Enumeration Date	:	03/02/2021
Last Update Date	:	03/29/2026

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Directions to “ TYLER KING MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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