Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tyler Jake Tolman

Individual provider Family Medicine Physician · NPI 1740774439

Tyler Jake Tolman is a Family Practice in Eagle, Idaho. Qualified in 2018, 8 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
8
Licensed in
ID
In the registry since
2018
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

3101 E State St Ste AND2107
Eagle, ID 83616-6232
Phone: (208) 473-3500
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence O-1336 (ID)
Family Medicine Physician Taxonomy 207Q00000X · Licence MRO-1739 (ID)

Record details

NPI number1740774439
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 18, 2018
Last updated in NPPESNovember 15, 2021
Certification dateNovember 15, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Eagle