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

Tyler Roberts, PA-C

Individual provider Physician Assistant · NPI 1164033353

Tyler Roberts, PA-C is a Physician Assistant in Lugoff, South Carolina. Works from 2 locations. Licensed in South Carolina.

Licensed in
SC
In the registry since
2020
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

15 Exchange Dr
Lugoff, SC 29078-9198
Phone: (803) 670-8238
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • Private, Louisville, KY 40241 — (502) 322-7192

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Physician Assistant Taxonomy 363A00000X · Licence 4796 (SC)

Record details

NPI number1164033353
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 12, 2020
Last updated in NPPESMay 2, 2023
Certification dateMay 2, 2023

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