Tyler Kinson Palbicke, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

37107 Issued in NE

Practice address

224 W D.L. Ingram Avenue
BLDG. 1408
Cannon Afb, NM 88103-5014

Phone

(575) 784-2778

NPI assigned

Jun 12, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1790469799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3517 ADENMOR CT APT 2B",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881013058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 W D.L. INGRAM AVENUE",
            "address_2": "BLDG. 1408",
            "city": "CANNON AFB",
            "state": "NM",
            "postal_code": "881035014",
            "telephone_number": "575-784-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Fisher St",
            "address_purpose": "LOCATION",
            "city": "Keesler AFB",
            "state": "MS",
            "postal_code": "395342508",
            "country_code": "US",
            "telephone_number": "228-376-3092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALBICKE",
        "first_name": "TYLER",
        "middle_name": "KINSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-12",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "37107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thien H Nguyen, PHARM.D.
• Matthew John Nielsen, D.D.S.
• Jason P Nolz, O.D.
• Andrew M Null
• Viviana Nunez, LPN
• Randi Parker, LCSW
• Anar J Patel, MD
• Sarah Alicia Paulson, PT, DPT
• John Michael Peffer, MD
• Maverick Lee Peterson

• General Practice Physician in Cannon Afb, NM
• Providers in Cannon Afb, NM by specialty
• General Practice Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.