Smith, Tyler Wilson
Smith, Tyler Wilson is an individual health care provider with primary practice located at 4015 Lake Otis Pkwy Ste 201 , Anchorage AK 99508-5235. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Trauma, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Trauma is his primary health care specialty. Smith, Tyler Wilson can be contacted via phone (907) 771-3500.Contact Information
Primary practice address
4015 Lake Otis Pkwy Ste 201
Anchorage AK 99508-5235
Phone: (907) 771-3500
Fax: (907) 771-3550
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Trauma | 207XX0801X | 2019007890 | Missouri |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 2019007890 | Missouri |
| Allopathic & Osteopathic Physicians / Orthopaedic Trauma | 207XX0801X | 162642 | Alaska |
Profile Details
| NPI number | 1508270877 |
|---|---|
| LBN Legal business name | Smith, Tyler Wilson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2014 |
| Last updated | Jan 26th, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508270877 | NPPES |
| Alaska | MEDICAID | 1708615 |
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