Mr Tyler Wilson, DO is a medicare enrolled "Internal Medicine" provider in Apo, Armed Forces Pacific. His current practice location is
Unit 5024 Box 35th, Apo, Armed Forces Pacific. You can reach out to his office (for appointments etc.) via phone at
(315) 226-6288.
Mr Tyler Wilson is licensed to practice in California (license number 20A21080) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1407208499.
Healthcare Provider's Profile
Full Name | Mr Tyler Wilson |
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Gender | Male |
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Speciality | Internal Medicine |
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Location | Unit 5024 Box 35th, Apo, Armed Forces Pacific |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1407208499
- Provider Enumeration Date: 07/01/2016
- Last Update Date: 08/04/2024
Medicare PECOS Information:
- PECOS PAC ID: 9537549688
- Enrollment ID: I20220706003609
Medical Identifiers
Medical identifiers for Mr Tyler Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1407208499 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
207R00000X | Internal Medicine | 20A21080 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Tyler Wilson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Tyler Wilson, DO 101 Bodin Cir, Fairfield, CA 94535-1809 Ph: (707) 423-3000 | Mr Tyler Wilson, DO Unit 5024 Box 35th, Apo, AP 96319-5024 Ph: (315) 226-6288 |
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