Healthcare Provider Details

I. General information

NPI: 1629872874
Provider Name (Legal Business Name): WILLIAM JAMES TYREE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2025
Last Update Date: 04/10/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4777 E GALBRAITH RD
CINCINNATI OH
45236-2814
US

IV. Provider business mailing address

110 OSBORNE FORD RD
SMITHS GROVE KY
42171
US

V. Phone/Fax

Practice location:
  • Phone: 513-686-5446
  • Fax: 513-686-6868
Mailing address:
  • Phone: 270-202-0287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: