Hickle, Tyson

Hickle, Tyson is an individual health care provider with primary practice located at 250 Hospital Pl , Soldotna AK 99669-7559. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Hickle, Tyson can be contacted via phone (907) 714-4502.

Contact Information

Primary practice address
250 Hospital Pl Soldotna AK 99669-7559
Phone: (907) 714-4502
Fax: (907) 714-4696
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 0116028145 Virginia
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD61440052 Washington

Profile Details

NPI number 1699193979
LBN Legal business name Hickle, Tyson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2014
Last updated Oct 20th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699193979 NPPES
Alaska MEDICAID 1699522

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