Provider Demographics
NPI:1497013577
Name:TYREE, NAOMI LEANN (BS, MD)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:LEANN
Last Name:TYREE
Suffix:
Gender:F
Credentials:BS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 FRANKS PKWY
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-6249
Mailing Address - Country:US
Mailing Address - Phone:330-899-0103
Mailing Address - Fax:
Practice Address - Street 1:1835 FRANKS PKWY
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-6249
Practice Address - Country:US
Practice Address - Phone:330-899-0103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.125667207R00000X
OH35125667207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine