Tyler Mark Stall, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

0101260329 Issued in VA

Practice address

2510 Gaskins Rd
Henrico, VA 23238-1481

Phone

(757) 897-4843

NPI assigned

Jun 14, 2010

Sex

Male

Sole proprietor

Yes

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1831410828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 GASKINS RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232381481",
            "telephone_number": "757-897-4843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 GASKINS RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232381481",
            "telephone_number": "757-897-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALL",
        "first_name": "TYLER",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-14",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "VA",
            "license": "0101260329",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KS",
            "license": "9407434",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Lynn Spencer, PHARMD
• Mary Katherine Spicer
• Shirley Nicole Spruill, CNA
• SRM Healthcare Services, LLC
• Meghan Staat
• Standing in the Gap, LLC
• Staples Mill Family Dentistry PLLC
• Harvey P Staples
• Stat Lab Testing
• Tracie' L. Steele, LMT

• Plastic Surgery Physician in Henrico, VA
• Providers in Henrico, VA by specialty
• Plastic Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; 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.