Individual
TYLER SCOTT NOBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2376 CYPRESS CIR STE 300, CONWAY, SC 29526-8995
(843) 353-3460
(843) 353-3461
Mailing address
210 VILLAGE CENTER BLVD STE 140, MYRTLE BEACH, SC 29579-6706
(843) 353-3460
(843) 353-3461
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
OS13810
FL
207X00000X
Orthopaedic Surgery Physician
OT014290
PA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
39926
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017374400
—
FL
05
—
399269
—
SC
01
—
OT014290
LICENSE NO
PA
01
—
S4WBP
BCBS
FL
Enumeration date
04/06/2011
Last updated
07/20/2022
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