Individual
DR. TYRA LANEE TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4645 AUGUSTA ROAD, BEECH ISLAND, SC 29842
(803) 593-9283
(803) 593-0607
Mailing address
4645 AUGUSTA RD, BEECH ISLAND, SC 29842-7265
(803) 593-9283
(803) 593-0607
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME 107184
FL
Other
Enumeration date
06/29/2007
Last updated
06/11/2012
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