Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tysen J Petre, DO

Individual provider Family Medicine Physician · NPI 1871642470

Tysen J Petre, DO is a Family Practice in Kirksville, Missouri. Graduated from At Still University of Health Sciences, College of Osteo Med, Kirksville in 2004, 22 years ago. Practices with Macon County Samaritan Hospital, a 36-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
22
Trained at
At Still University of Health Sciences, College of Osteo Med, Kirksville
Licensed in
MO
In the registry since
2007
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

1611 S Baltimore St
Kirksville, MO 63501-4518
Phone: (660) 665-7575
Fax: (660) 665-7576
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1206 N Missouri St, Macon, MO 63552-2149 — (660) 395-7575

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 2006004444 (MO)

Record details

NPI number1871642470
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJanuary 10, 2007
Last updated in NPPESSeptember 16, 2025
Certification dateSeptember 16, 2025
Mailing address1611 S Baltimore St, Kirksville, MO 63501-4518

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolAT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated 2004 (22 years in practice)
Group practice Macon County Samaritan Hospital — 36 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Kirksville