Severance, Tyler S
Severance, Tyler S is an individual health care provider with primary practice located at One Hospital Dr , Columbia MO 65212-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, which is considered as his primary health care specialty. Severance, Tyler S can be contacted via phone (573) 882-3961.Contact Information
Primary practice address
One Hospital Dr
Columbia MO 65212-0001
Phone: (573) 882-3961
Fax: (573) 884-4277
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology | 2080P0207X | 2022034889 | Missouri |
| Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology | 2080P0207X | 01080551A | Indiana |
Profile Details
| NPI number | 1366822579 |
|---|---|
| LBN Legal business name | Severance, Tyler S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 2nd, 2015 |
| Last updated | Nov 28th, 2022 - about 3 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 | 1366822579 | NPPES |
| Missouri | MEDICAID | 200114355 | |
| Missouri | MEDICAID | 201295020 |
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