Individual
DR. WILLIAM CRAIG TYREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
2085R0001X
Radiation Oncology Physician
Primary
34721
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000364528
ANTHEM INDIVIDUAL PIN NUM
KY
05
—
64047186
—
KY
Enumeration date
07/19/2005
Last updated
05/21/2012
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