Basic Information
| Provider Information | |||||||||
| NPI: | 1427008184 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KIRBY | ||||||||
| FirstName: | TYLER | ||||||||
| MiddleName: | O'NEAL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2705 | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358042705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2568016048 | ||||||||
| FaxNumber: | 2568016218 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 SIVLEY RD SW | ||||||||
| Address2: | SUITE 620 | ||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358015134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2562654600 | ||||||||
| FaxNumber: | 2562654651 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2006 | ||||||||
| LastUpdateDate: | 01/11/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VX0201X | ME95793 | FL | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecologic Oncology | 207VX0201X | MD.23784 | AL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecologic Oncology |
ID Information
| ID | Type | State | Issuer | Description | 051530398 | 01 | AL | BLUE CROSS | OTHER | 009969155 | 05 | AL | MEDICAID | P01335306 | 01 | AL | RAILROAD PTAN | OTHER | 051514743 | 01 | AL | BLUE CROSS | OTHER | 155957 | 05 | AL | MEDICAID | 009923185 | 05 | AL | MEDICAID | 511-44257 | 01 | AL | BLUE CROSS | OTHER | 051514740 | 01 | AL | BLUE CROSS | OTHER | 051514741 | 01 | AL | BLUE CROSS | OTHER | 051523912 | 01 | AL | BLUE CROSS | OTHER | 009923175 | 05 | AL | MEDICAID | P00008044 | 01 | AL | RAILROAD MEDICARE | OTHER | 051514740 | 05 | AL | MEDICAID | 102I986140 | 01 | AL | MEDICARE PTAN | OTHER | 009923165 | 05 | AL | MEDICAID | 051514742 | 01 | AL | BLUE CROSS | OTHER |