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Organization
W. CRAIG TYREE, MD, PLC
Active
Organization
W. CRAIG TYREE, MD, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM CRAIG TYREE MD (OWNER/MANAGER)
(270) 659-0184
Entity
Organization
Contact information
Practice address
103 TRISTA LN, GLASGOW, KY 42141-3482
(270) 659-0184
(270) 651-9264
Mailing address
PO BOX 416, GLASGOW, KY 42142-0416
(270) 659-0184
(270) 651-9264
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
34721
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000364525
ANTHEM GROUP NUMBER
KY
05
—
64047186
—
KY
Enumeration date
10/16/2007
Last updated
11/12/2009
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