Provider Demographics
NPI:1952344459
Name:TYRONE MEDICAL ASSOCIATES SPECS
Entity Type:Organization
Organization Name:TYRONE MEDICAL ASSOCIATES SPECS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE LEADER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-684-3101
Mailing Address - Street 1:3 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:PA
Mailing Address - Zip Code:16686-1810
Mailing Address - Country:US
Mailing Address - Phone:814-684-3101
Mailing Address - Fax:
Practice Address - Street 1:3 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:PA
Practice Address - Zip Code:16686-1810
Practice Address - Country:US
Practice Address - Phone:814-684-3101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty