DR. TYLER NICKLE DO NPI 1972097418

NPI Information

NPI: 1972097418
Provider Name: DR. TYLER NICKLE, DO
Classification: General Practice - 208D00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
8990 W CLOUDWOOD DR
MARANA, AZ
ZIP 85653
Phone: (801) 347-4568
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DR. Tyler Nickle, DO is a general practice in Marana, AZ with 6 years of experience. DR. Tyler Nickle, DO NPI is 1972097418. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduation Year:2018

The provider's business location address is:

8990 W CLOUDWOOD DR
MARANA, AZ
ZIP 85653-892
Phone: (801) 347-4568

The NPI 1972097418 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/19/2018 and was last updated on 4/1/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0800X	Psychiatry & Neurology	Psychiatry	R3067	ARIZONA	No
2	208D00000X	General Practice		008407	ARIZONA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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