Individual
DR. DAVID TYLER TREESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7430 JEFFERSON BLVD, STE 200, LOUISVILLE, KY 40219-6159
(502) 968-3010
(502) 968-0035
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45645
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000781114
ANTHEM - NCMA
KY
01
—
000000783923
ANTHEM - NMA
KY
01
—
138687
SIHO - NCMA
KY
01
—
50043205
PASSPORT - NMA
KY
01
—
50043207
PASSPORT - NCMA
KY
05
—
7100132910
—
KY
Enumeration date
04/10/2009
Last updated
09/12/2016
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