Individual provider · Type 1 NPI

Tyra Denee Gaylord, MD

Specialist · South Bend, IN

NPI number 1093925307 Active

Practice location

615 N Michigan St
South Bend, IN 46601-1033

Call (574) 647-1000 Map

Mailing address

15446 Regis Ct
Granger, IN 46530-6266

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X01042658A (IN)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1093925307

Tyra Denee Gaylord, MD's National Provider Identifier is 1093925307, issued on May 23, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in South Bend, IN. The record was last updated on Jul 8, 2007.