Reynolds, Tyler Shane

Reynolds, Tyler Shane is an individual health care provider with primary practice located at 3800 S National Ave Ste 600 , Springfield MO 65807-5249. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care. Allopathic & Osteopathic Physicians / Surgical Critical Care is his primary health care specialty. Reynolds, Tyler Shane can be contacted via phone (417) 875-3000.

Contact Information

Primary practice address
3800 S National Ave Ste 600 Springfield MO 65807-5249
Phone: (417) 875-3000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 2022007281 Missouri
Allopathic & Osteopathic Physicians / Surgery 208600000X 074569 Georgia
Allopathic & Osteopathic Physicians / Surgical Critical Care 2086S0102X ME163370 Florida
Allopathic & Osteopathic Physicians / Surgery 208600000X A101986 California

Profile Details

NPI number 1376737874
LBN Legal business name Reynolds, Tyler Shane
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2007
Last updated Aug 10th, 2023 - about last year

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 1376737874 NPPES
Missouri MEDICAID 200116135

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