Tynes, Kerry W

Tynes, Kerry W is an individual health care provider with primary practice located at 1455 E Bert Kouns Loop , Shreveport LA 71105-5634. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Tynes, Kerry W can be contacted via phone (318) 798-4400.

Contact Information

Primary practice address
1455 E Bert Kouns Loop Shreveport LA 71105-5634
Fax: (318) 798-4621
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 025696 Louisiana

Profile Details

NPI number 1538152426
LBN Legal business name Tynes, Kerry W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2005
Last updated Dec 11th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538152426 NPPES
Texas Other 177481202 TEXAS MEDICAID NUMBER
Texas MEDICAID 1041882 TEXAS MEDICAID NUMBER
Texas Other P00282489 TEXAS MEDICAID NUMBER
Texas Other 1053315846 TEXAS MEDICAID NUMBER

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