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General NPI Number Information
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NPI Number | 1962899245
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Entity Type | Individual
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Provider Name | ZACHARY MARK TYERMAN MD
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Gender | Male
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Dates
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Enumeration Date | 04/23/2015
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | ONE HOSPITAL DR
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City | COLUMBIA
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State | MO
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Zip | 65212-0001
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Country | US
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Telephone | 573-882-5609
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Fax | 573-884-6054
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Provider Business Mailing Address
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Address Line | PO BOX 843966
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City | KANSAS CITY
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State | MO
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Zip | 64184-3966
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Country | US
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Telephone | 573-884-3300
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Fax | 573-884-0943
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | T9809
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2024050396
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License Number State | MO
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