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Contact Information

ADAIR DEBERRY CARLISLE, DO
630 S FLEISHEL AVE
TYLER, TX75701-2041
 Phone: 903-606-5560
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Trauma Surgery

2086S0127X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for ADAIR DEBERRY CARLISLE · (Female)

NPI # 1730110651
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 07/06/2006
Last updated 06/02/2025 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • AZ License # 007921
  • NE License # 1974
  • OK License # 6836
  • TX License # M0050
  • WI License # 71035-21
  • OK Medicaid 200908280A
  • TX Medicaid 197530202
  • TX Other 8AN626 BCBSTX
  • TX Other P02531927 MEDICARE RAIL ROAD
Hospital affiliation(s)
  • LEWISGALE MEDICAL CENTER - (Acute Care)
    1900 ELECTRIC ROAD
    SALEM, VA 24153
  • NORTH SHORE UNIVERSITY HOSPITAL - (Acute Care)
    300 COMMUNITY DRIVE
    MANHASSET, NY 11030
  • PECONIC BAY MEDICAL CENTER - (Acute Care)
    1300 ROANOKE AVENUE
    RIVERHEAD, NY 11901
  • SOUTHSIDE HOSPITAL - (Acute Care)
    301 EAST MAIN STREET
    BAY SHORE, NY 11706
  • WELLSTAR KENNESTONE HOSPITAL - (Acute Care)
    677 CHURCH STREET
    MARIETTA, GA 30060
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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