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Individual
DR. ROBERT FENTON TYREE
Active
Individual
DR. ROBERT FENTON TYREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
31621
WI
207Q00000X
Family Medicine Physician
Primary
35-06-4727-T
OH
207Q00000X
Family Medicine Physician
7690
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000538559
ANTHEM
OH
01
—
01-04353
UHC
OH
05
—
0213254
—
OH
01
—
2017149
AETNA
OH
01
—
314379443
KLAIS
OH
01
—
314379443-159
CENTRAL BENEFITS
OH
01
—
9327536-001
CIGNA
OH
Enumeration date
05/28/2005
Last updated
11/21/2013
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