Tyson, Martin S.

Tyson, Martin S. is an individual health care provider with primary practice located at 1155 W Parkview St Suite 1G, Bolivar MO 65613-8279. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Trauma Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Tyson, Martin S. can be contacted via phone (417) 326-8700.

Contact Information

Primary practice address
1155 W Parkview St Suite 1G Bolivar MO 65613-8279
Phone: (417) 326-8700
Fax: (417) 328-6755
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 2001010358 Missouri
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X 2001010358 Missouri

Profile Details

NPI number 1851468987
LBN Legal business name Tyson, Martin S.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2006
Last updated Dec 10th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851468987 NPPES
Missouri Other 020049033 RAILROAD MEDICARE
Missouri Other 431560263006 RAILROAD MEDICARE
Missouri MEDICAID 245315106 RAILROAD MEDICARE

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