Gaylord, Tyra Denee

Gaylord, Tyra Denee is an individual health care provider with primary practice located at 615 N Michigan St , South Bend IN 46601-1033. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Gaylord, Tyra Denee can be contacted via phone (574) 647-1000.

Contact Information

Primary practice address
615 N Michigan St South Bend IN 46601-1033
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 01042658A Indiana

Profile Details

NPI number 1093925307
LBN Legal business name Gaylord, Tyra Denee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2007
Last updated Jul 8th, 2007 - about 17 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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