Individual provider Active NPI

Tyler Wayne Mullikin, DO

  • General Practice Physician
  • Tinker AFB, OK
National Provider Identifier
1538915509
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
9357 Issued in OK
Practice address
7050 Air Depot Blvd BLDG 1094
Tinker AFB, OK 73145-8716
Phone
(405) 582-6609
Fax
(405) 736-3619
NPI assigned
Apr 29, 2024
Last updated
Nov 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 9357 OK Primary

Addresses

Primary practice location

7050 Air Depot Blvd BLDG 1094
Tinker AFB, OK 73145-8716

Mailing address

7050 Air Depot Blvd BLDG 1094
Tinker AFB, OK 73145-8716
Phone (405) 582-6609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
9357OKMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1538915509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7050 AIR DEPOT BLVD BLDG 1094",
            "city": "TINKER AFB",
            "state": "OK",
            "postal_code": "731458716",
            "telephone_number": "405-582-6609",
            "fax_number": "405-736-3619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7050 AIR DEPOT BLVD BLDG 1094",
            "city": "TINKER AFB",
            "state": "OK",
            "postal_code": "731458716",
            "telephone_number": "405-582-6609",
            "fax_number": "405-736-3619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIKIN",
        "first_name": "TYLER",
        "middle_name": "WAYNE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-29",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OK",
            "license": "9357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinker AFB, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.