Tyrell Scurlock

Contractor · Saint Louis, MO

Individual Active NPI

NPI number 1104212018

Practice location

11960 Westline Industrial Dr
201
Saint Louis, MO 63146-3209
Phone
(314) 575-8163

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NPI record

NPI
1104212018
Entity type
Individual (Type 1)
Enumeration date
April 8, 2015
Last updated
April 8, 2015
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Contractor Primary 171W00000X 2003020843 MO

Mailing address

PO Box 23331
Saint Louis, MO 63156-3331
Phone
(314) 575-8163

About Tyrell Scurlock

Tyrell Scurlock is a healthcare provider registered in the NPI registry with the primary taxonomy Contractor (code 171W00000X). The practice location is 11960 Westline Industrial Dr, 201, Saint Louis, MO 63146-3209. The NPI number 1104212018 was assigned on April 8, 2015 and the record was last updated on April 8, 2015.

Tyrell Scurlock lists a license in the registry: #2003020843 (MO) for Contractor. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Tyrell Scurlock?

The NPI number is 1104212018.

What is the phone number of Tyrell Scurlock?

The phone number listed for the practice location is (314) 575-8163.

Where is Tyrell Scurlock located?

11960 Westline Industrial Dr, 201, Saint Louis, MO 63146-3209.

What is the taxonomy code for Tyrell Scurlock?

The primary taxonomy code is 171W00000X – Contractor.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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