Individual
DR. DANIEL JOSEPH TIVENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2829
Mailing address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2829
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2010003274
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992926539
—
MO
Enumeration date
05/01/2007
Last updated
04/15/2016
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