DANIEL LEWIS TYSON


Address: 208 W Casablanca Ave, Clovis, NM 88103-5009
Phone: 5757847801

DANIEL LEWIS TYSON (NPI# 1245474667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1245474667
Entity Type Individual
Full Name DANIEL LEWIS TYSON
Credential IDMT
Practice Address 208 W Casablanca Ave
Clovis
NM 88103-5009
Practice Telephone 5757847801
Mailing Telephone 5757847801
Enumeration Date 2009-04-29
Last Update Date 2009-04-29
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1003X Military Health Care Provider
Specialization: Independent Duty Medical Technicians
Other Service Providers

Other Providers DANIEL TYSON

NPI Name Taxonomy Address Enumeration
1912428822 Daniel Joseph Tyson Physical Therapist 3200 Vine St, Cincinnati, OH 45220-2213 2017-06-30

Office Location

Street Address 208 W CASABLANCA AVE
City CLOVIS
State NM
Zip Code 88103-5009

Providers in the same location

NPI Name Taxonomy Address Enumeration
1619964947 Roseanne Carol Warner Nurse Practitioner 208 W Casablanca Ave, 27 Medical Group Bldg 1400 Cannon Afb, Clovis, NM 88103-5009 2005-10-03
1861902041 Katherine Ann Craft Dietitian, Registered 208 W Casablanca Ave, Clovis, NM 88103-5009 2017-10-02
1801132220 Dena Levari Military Health Care Provider 208 W Casablanca Ave, Clovis, NM 88103-5009 2012-12-13
1851372858 Robert Dale Bitner Physician Assistant 208 W Casablanca Ave, Bldg 1400 Cannon Afb 27 Medical Group, Clovis, NM 88103-5009 2005-11-08
1043208838 Marla Dianne Buckles Nurse Practitioner 208 W Casablanca Ave, 27 Medical Group Bldg 1400 Cannon Afb, Clovis, NM 88103-5009 2005-10-06

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1346747151 Isabella Wolak Pharmacist 224 D L Ingram Blvd, Cannon Afb, NM 88103 2018-04-09
1225480544 Stacey Tatro Dentist 224 West D.l. Ingram Ave., Bldg 1408, Cannon Afb, NM 88103 2016-07-11
1871965673 Chad Bryan Carter Dentist 224 W Dl Ingram Ave, Sgpd/dental Clinic, Cannon Air Force Base, NM 88103 2015-10-20
1740660836 Terah Clifford Dental Hygienist 224 W Dl Ingram Blvd, Bldg 1408 Dental Clinic, Cannon Afb, NM 88103 2015-06-03
1528452208 Taylor Bottari Physician Assistant 208 W Dl Ingram, Cannon Afb, NM 88103 2015-03-20
1588071328 Gretchen Evelynn Szymanski Nurse Practitioner Cannon Afb, 224 W D.l. Ingram Blvd, Cannon Afb, NM 88103 2014-07-14
1396155206 Jennifer Brynn Bendokas Physician Assistant 224 West Dl Ingram Avenue, Cannon Afb, NM 88103 2014-04-30
1366889487 Jeremy Michael Strohmayer General Practice 511 Chindt Blvd Building 300, 27soss/osm, Cannon Afb, NM 88103 2013-05-30
1356622401 Matthew John Nielsen Dentist 224 W D.l. Ingram, Bld. 1408, Cannon Afb, NM 88103 2011-09-02
1689965485 Bryan Wade Sixkiller Optometrist 27th Somdg, 208 W. Casa Blanca Ave., Apo, AA 88103 2011-04-27
Find all providers in zip 88103

Taxonomy Information

Taxonomy Code 1710I1003X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Medical Technicians

Taxonomy Definition

An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
Notes: Source: Air Force Surgeon General Office [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1144797556 William Murphy Whittle Military Health Care Provider 2000 Hallum St, Clovis, NM 88101-8684 2018-10-24
1265983068 Yurikoaokio Motomochi Livas Military Health Care Provider 209 Wilmington Cir, Clovis, NM 88101-9382 2016-10-18
1831438357 John Frederick Rinaldi Military Health Care Provider 3500 Adenmore Ct, Apt C, Clovis, NM 88101 2013-02-04
1740583350 Norma P Grandberry Military Health Care Provider 1501 Westchester St, Clovis, NM 88101-4638 2010-12-21
1609186139 Jeramy Byrd Military Health Care Provider 9410 A Vermont Court, Clovis, NM 88101 2010-10-18
1477879708 Christopher Gordon Brown Military Health Care Provider 717 Sandia Dr, Clovis, NM 88101-4123 2010-04-12
1396989968 Luis Alberto Hallman Military Health Care Provider 3516 Adenmor Ct, Unit B, Clovis, NM 88101-2820 2009-04-28
1689271736 Sinead Catherine Brosnan Military Health Care Provider 208 D L Ingram Ave W, Clovis, NM 88103-5103 2020-10-01
1801132220 Dena Levari Military Health Care Provider 208 W Casablanca Ave, Clovis, NM 88103-5009 2012-12-13

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1801496625 Stephen Kreidler Military Health Care Provider 5453 Roosevelt Loop Ne, Rio Rancho, NM 87144-5218 2020-10-30
1134748692 Patrick James Scollon Military Health Care Provider 104 W D. L. Ingram Ave, Cannon Afb, Nm 88101, Cannon Afb, NM 88101 2020-04-14
1245614544 Rowland Coyle Military Health Care Provider 701 Stephen Moody Rd, Albuquerque, NM 87117 2015-07-16
1972939585 Eugene Navarro Tabita Military Health Care Provider 4050a Greenhouse Pl Se, Albuquerque, NM 87116-3008 2013-09-16
1043553217 Amanda Colyer Military Health Care Provider 2050 2nd St Se # A, Albuquerque, NM 87117-5522 2013-04-05
1003176389 Ricky Franco Vela Military Health Care Provider 8101a W Sandia Cir Se, Albuquerque, NM 87116-5501 2012-05-21
1194041426 Philip Ofimiano Borde Jr. Military Health Care Provider 4660 Mesa Rico Dr, Las Cruces, NM 88011-7228 2010-04-12
1285958017 Michael Wayne Mcfadden Military Health Care Provider 2309 Saguaro Loop, Alamogordo, NM 88310-7775 2010-03-23
1952630642 Michael B Stull Military Health Care Provider 904 S Dallas Ave Apt 3, Portales, NM 88130-6028 2009-12-09
1598909012 Martin Oleen Jensen Military Health Care Provider 119 E Arcadia Ave Bldg 622, 27 Special Operations Support Sqdn/osm, Cannon Afb, NM 88103-5112 2009-04-28
Find all providers with the same taxonomy

Competitor

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City CLOVIS
Zip Code 88103

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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