Tyson, Mary Lynn
Tyson, Mary Lynn is an individual health care provider with primary practice located at 1727 Wrightsboro Rd Suite B, Augusta GA 30904-4074. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Tyson, Mary Lynn can be contacted via phone (706) 736-8170.Contact Information
Primary practice address
1727 Wrightsboro Rd Suite B
Augusta GA 30904-4074
Phone: (706) 736-8170
Fax: (706) 736-8184
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 030683 | Georgia |
Profile Details
| NPI number | 1780669218 |
|---|---|
| LBN Legal business name | Tyson, Mary Lynn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 7th, 2005 |
| Last updated | Oct 21st, 2013 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780669218 | NPPES |
| Georgia | MEDICAID | 000902063V | |
| Georgia | MEDICAID | 000606317B |
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