Individual
TYLER S SEVERANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
ONE HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-3961
(573) 884-4277
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
01080551A
IN
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
2022034889
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200114355
—
MO
05
—
201295020
—
IN
Enumeration date
06/02/2015
Last updated
11/28/2022
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