Individual
SHANNON K. TYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2451 FILLINGIM ST, MASTIN BLDG., MOBILE, AL 36617-2238
(251) 470-5890
(251) 471-7925
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 470-5890
(251) 471-7925
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
24784
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009935856
—
AL
05
—
009935857
—
AL
05
—
07639500
—
MS
05
—
1582034
—
LA
05
—
274994700
—
FL
01
—
51535529
BCBS
AL
01
—
51535531
BCBS
AL
01
—
92-00090
UNITED HEALTHCARE
AL
Enumeration date
05/27/2006
Last updated
05/12/2015
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