Anderson, Tynese Simone

Anderson, Tynese Simone is an sole proprietor health care provider with primary practice located at 1021 W 5Th Ave , Gary IN 46402-1703. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Anderson, Tynese Simone can be contacted via phone (219) 880-1190.

Contact Information

Primary practice address
1021 W 5Th Ave Gary IN 46402-1703
Fax: (219) 378-7147
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01084389A Indiana

Profile Details

NPI number 1528327731
LBN Legal business name Anderson, Tynese Simone
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 8th, 2012
Last updated Jan 29th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528327731 NPPES
Indiana Other 300042215 INDIANA LPI

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