Organization
RODNEY D. TYSON MD,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODNEY DONALD TYSON SR. M.D. (PRESIDENT)
(229) 896-3424
Entity
Organization
Contact information
Practice address
103 JAMES ST, ADEL, GA 31620-1504
(229) 896-3424
(229) 896-3838
Mailing address
103 JAMES ST, ADEL, GA 31620-1504
(229) 896-3424
(229) 896-3838
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
038994
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00703425A
—
GA
01
—
507222
BCBS PROVIDER NUMBER
GA
Enumeration date
10/28/2007
Last updated
01/04/2010
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