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Individual

DR. MARSHALL SCOTT TYNES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1600 22ND AVE, MEDICAL TOWERS III, MERIDIAN, MS 39301-3223
(601) 483-5322
(601) 581-2289
Mailing address
PO BOX 749215, ATLANTA, GA 30374-9215
(901) 226-3186

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14897
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
009700450
ALMCD
AL
05
0117444
MS
01
073075294TYN
AL BCBS
AL
01
279588
TRICARE
Enumeration date
10/06/2006
Last updated
10/28/2024
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