Healthcare Provider Details

I. General information

NPI: 1457191892
Provider Name (Legal Business Name): TWO RIVERS PHYSICIANS, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2024
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

946 E REED ST
HAYTI MO
63851-1243
US

IV. Provider business mailing address

1602 AVENUE Q
LUBBOCK TX
79401-4732
US

V. Phone/Fax

Practice location:
  • Phone: 888-264-0330
  • Fax:
Mailing address:
  • Phone: 888-264-0330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. HARRY KYLE SHEETS
Title or Position: OWNER
Credential: MD
Phone: 888-264-0330