Individual
DR. THOMAS A TYREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1475 KISKER RD, SUITE 200, SAINT CHARLES, MO 63304-8781
(636) 498-5850
(636) 669-2401
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-0001
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
R2P42
MO
207R00000X
Internal Medicine Physician
Primary
R2P42
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203043609
—
MO
Enumeration date
03/29/2006
Last updated
11/16/2020
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