Tyra Denee Gaylord, M.D.

NPI #1093925307 in South Bend, Indiana

Provider Information

NPI Number: 1093925307
Entity Type: Individual
Name: Tyra Denee Gaylord, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: M.D.
Enumeration Date: May 23, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 615 N MICHIGAN ST
City: South Bend
State: Indiana
ZIP Code: 46601-1033
Phone: (574) 647-1000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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