Ty Mauldin, is a
Student In An Organized Health Care Education/training Program based in Sioux Falls, South Dakota. Ty Mauldin is licensed to practice in Florida (license number ) and his current practice location is
1316 W Wicklow Ct, Sioux Falls, South Dakota. He can be reached at his office (for appointments etc.) via phone at
(605) 836-1227.
NPI number for Ty Mauldin is 1134880453 and his current mailing address is 1316 W Wicklow Ct, Sioux Falls, South Dakota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1134880453.
Provider's Profile
| Full Name | Ty Mauldin |
|---|
| Gender | Male |
|---|
| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 1316 W Wicklow Ct, Sioux Falls, South Dakota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1134880453
- Provider Enumeration Date: 01/08/2022
- Last Update Date: 08/18/2022
Medical Identifiers
Medical identifiers for Ty Mauldin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1134880453 | NPI | - | NPPES |
| 5020425893002 | Other | TN | SS NETWORK ALLIANCE # |
| 96440 | Other | CA | ACCME (ACCREDITATION COUNCIL FOR CONTINUING MEDICAL EDUCATION) |
| TAMGC05152013 | Other | NC | GREENSBORO COLLEGE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363AM0700X | Physician Assistant - Medical | GC05112013 (South Dakota) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (Florida) | 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. Ty Mauldin is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ty Mauldin,
1316 W Wicklow Ct,
Sioux Falls, SD 57108-3252
Ph: (605) 836-1227 | Ty Mauldin,
1316 W Wicklow Ct,
Sioux Falls, SD 57108-3252
Ph: (605) 836-1227 |
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