Petre, Tysen J
Petre, Tysen J is an individual health care provider with primary practice located at 800 W Jefferson St , Kirksville MO 63501-1443. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Petre, Tysen J can be contacted via phone (660) 665-4432.Contact Information
Primary practice address
800 W Jefferson St
Kirksville MO 63501-1443
Phone: (660) 665-4432
Fax: (660) 956-4392
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2006004444 | Missouri |
Profile Details
| NPI number | 1871642470 |
|---|---|
| LBN Legal business name | Petre, Tysen J |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 10th, 2007 |
| Last updated | May 20th, 2020 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871642470 | NPPES |
| Missouri | Other | BNDD | 400608434 |
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