Mike O Tyler Jr. (NPI# 1750348371, PAC ID# 2567421829) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEUROSURGERY.
| Nation Provider ID (NPI) | 1750348371 |
| PAC ID by PECOS | 2567421829 |
| Professional Enrollment ID | I20041004000772 |
| Full Name | Mike O Tyler Jr. |
| Organization Legal Name | SOUTHERN COAST SPECIALISTS, LLC |
| Address |
9565 Hwy 78 Bldg 100 Ladson SC 29456-4118 |
| Phone Number | 8435537615 |
| Gender | M |
| Credential | MD |
| Medical School | MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE |
| Graduation Year | 1976 |
| Primary Specialty | NEUROSURGERY |
| Group Practice PAC ID | 9234484577 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420079 | TRIDENT MEDICAL CENTER |
| 420030 | COLLETON MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 9565 Hwy 78, Bldg 100, Ladson, SC 29456-4118 | 8435537615 | SOUTHERN COAST SPECIALISTS, LLC |
| Organization Legal Name | SOUTHERN COAST SPECIALISTS, LLC |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William Blane Richardson | Anesthesiology | Southern Coast Specialists, LLC | 9565 Hwy 78, Bldg 100, Ladson, SC 29456-4118 |
| Emmy Lou Olivia Hoke | Physician Assistant | Southern Coast Specialists, LLC | 9565 Hwy 78, Bldg 100, Ladson, SC 29456-4118 |
| Sabino J Dagostino | Neurosurgery | Southern Coast Specialists, LLC | 9565 Hwy 78, Bldg 100, Ladson, SC 29456-4118 |
| Street Address |
9565 HWY 78 BLDG 100 |
| City | LADSON |
| State | SC |
| Zip | 29456-4118 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David W Bang | Optometry | 9565 Hwy 78, Suite 900, Ladson, SC 29456-3912 | |
| William Blane Richardson | Anesthesiology | Southern Coast Specialists, LLC | 9565 Hwy 78, Bldg 100, Ladson, SC 29456-4118 |
| Emmy Lou Olivia Hoke | Physician Assistant | Southern Coast Specialists, LLC | 9565 Hwy 78, Bldg 100, Ladson, SC 29456-4118 |
| John E Thompson | Ophthalmology | 9565 Hwy 78, Bldg 200, Ladson, SC 29456-4118 | |
| Sabino J Dagostino | Neurosurgery | Southern Coast Specialists, LLC | 9565 Hwy 78, Bldg 100, Ladson, SC 29456-4118 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jill A Kirar | Chiropractic | Kirar Chiropractic Wellness Inc | 551 College Park Rd, Ladson, SC 29456-3329 |
| Zachary A Edmonds | Chiropractic | Kirar Chiropractic Wellness Inc | 551 College Park Rd, Ladson, SC 29456-3329 |
| Vance C Kirar | Chiropractic | Kirar Chiropractic Wellness Inc | 551 College Park Rd, Ladson, SC 29456-3329 |
| Millin C Budev | Ophthalmology | Carolina Cataract and Vision Center LLC | 137 Gateway Dr, Ladson, SC 29456-3552 |
| Kristiana D Neff | Ophthalmology | Carolina Cataract and Vision Center LLC | 137 Gateway Dr, Ladson, SC 29456-3552 |
| David Vroman | Ophthalmology | Carolina Cataract and Vision Center LLC | 137 Gateway Dr, Ladson, SC 29456-3552 |
| Michelle Ying | Ophthalmology | Carolina Cataract and Vision Center LLC | 137 Gateway Dr, Ladson, SC 29456-3552 |
| Jason F Baldwin | Optometry | Carolina Cataract and Vision Center LLC | 137 Gateway Dr, Ladson, SC 29456-3552 |
| Ronald G W Teed | Ophthalmology | 9565 Hwy 78 600, Ladson, SC 29456-4116 | |
| Mary Ashton Pratt | Physical Therapy | 3481 Ladson Rd, Ladson, SC 29456-4300 | |
| Find all physicians in zip 29456 | |||
| City | LADSON |
| Zip Code | 29456 |
| Specialty | NEUROSURGERY |
| City + Specialty | LADSON + NEUROSURGERY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.