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DR. ADAIR DEBERRY-CARLISLE D.O. NPI 1730110651


NPI Information

NPI: 1730110651
Provider Name: DR. ADAIR DEBERRY-CARLISLE, D.O.
Classification: Surgery - 2086S0127X
Entity Type: Individual

Specialization: Trauma Surgery

PECOS Registration: Yes

Address:
630 S FLEISHEL AVE
TYLER, TX
ZIP 75701
Phone: (903) 606-5560
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DR. Adair Deberry-carlisle, D.O. is a trauma surgery surgery in Tyler, TX with 21 years of experience. The provider is trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. DR. Adair Deberry-carlisle, D.O. NPI is 1730110651. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
Graduation Year:2003

The provider's business location address is:

630 S FLEISHEL AVE
TYLER, TX
ZIP 75701-041
Phone: (903) 606-5560

The NPI 1730110651 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/6/2006 and was last updated on 3/5/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208600000XSurgeryM0050TEXASNo
2208600000XSurgery1974NEBRASKANo
32086S0127XSurgeryTrauma Surgery6836OKLAHOMANo
42086S0127XSurgeryTrauma Surgery007921ARIZONANo
52086S0127XSurgeryTrauma Surgery71035-21WISCONSINNo
62086S0127XSurgeryTrauma Surgery1974NEBRASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18AN626OTHERTEXASBCBSTX
2197530202MEDICAIDTEXAS
3200908280AMEDICAIDOKLAHOMA
4P02531927OTHERTEXASMEDICARE RAIL ROAD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.