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:
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Health care specialties

SpecialtyCodeLicense #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 13 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 1780669218 NPPES
Georgia MEDICAID 000902063V
Georgia MEDICAID 000606317B

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