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Tyra Denee Gaylord, MD
Specialist in South Bend, Indiana
NPI 1093925307

Tyra Denee Gaylord is a Specialist based in Granger, IN. Tyra Denee Gaylord practices in South Bend, IN and has the professional credentials of MD. The NPI Number for Tyra Denee Gaylord is 1093925307 and holds a License No. 01042658A (Indiana).

The current practice location address for Tyra Denee Gaylord is 615 N Michigan St, South Bend, IN and can be reached out via phone at 574-647-1000.

Location: 615 N Michigan St, South Bend, IN, 46530-6266
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1093925307
Provider Name
Tyra Denee Gaylord
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
615 N Michigan St, South Bend, IN, 46530-6266
Phone Number
574-647-1000
Fax Number
Provider Enumeration Date
05/23/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
615 N Michigan St
City
South Bend
State
Indiana
Zip
46601-1033
Phone Number
574-647-1000
Fax Number
person
Provider Business Mailing Address Details
Address
615 N Michigan St
City
South Bend
State
Indiana
Zip
46601-1033
Phone Number
574-647-1000
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
01042658A (Indiana)
Definition
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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