Scott Walter Tycholiz, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601006684 Issued in MI

Practice address

5701 Bow Pointe Dr
Suite 120
Clarkston, MI 48346-3198

Phone

(248) 625-2273

Fax

(248) 625-6336

NPI assigned

Aug 22, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1609200021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DR",
            "address_2": "SUITE 120",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463198",
            "telephone_number": "248-625-2273",
            "fax_number": "248-625-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DR",
            "address_2": "SUITE 120",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463198",
            "telephone_number": "248-625-2273",
            "fax_number": "248-625-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYCHOLIZ",
        "first_name": "SCOTT",
        "middle_name": "WALTER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-22",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Tulpa, SCL, LLPC
• Dawn Turner, DO
• Jinave M Turner, MS, LLC
• Milana Turner, DPM
• Mary Turnwald
• Deborha Tycoliz Campbell, PSY. S. LLP
• Alexandra Ulewicz, BEHAVIOR TECHNICIAN
• Paul Ulewicz I, LMSW
• Hannah Ulrich, DPT
• Unicare Home Health, Inc

• Physician Assistant in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2013; 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.