Individual
DR. WARREN GLEN TYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6801 AIRPORT BLVD, 3RD FLOOR, MOBILE, AL 36608-3709
(251) 633-1900
Mailing address
2290 BURGETT RD, MOBILE, AL 36605-2801
(251) 375-6843
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD.28017
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009910137
—
AL
05
—
009910138
—
AL
05
—
009910139
—
AL
05
—
009910140
—
AL
01
—
1114010121
TRICARE SOUTH
AL
01
—
510-05895
BCBS
AL
01
—
510-05897
BCBS
AL
01
—
510-05900
BCBS
AL
01
—
510-65681
BCBS
AL
Enumeration date
10/02/2006
Last updated
08/29/2012
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