Individual
JAMES W. TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
123 GALLIMORE RD, BREVARD, NC 28712-9520
(828) 862-6218
(828) 877-5054
Mailing address
1125 COUNTRY CLUB RD, BREVARD, NC 28712-9515
(828) 862-6218
(828) 877-5054
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16164
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-70391
UNITED HEALTHCARE
NC
01
—
0637660001
PALMETTO GOV. SERVICES
NC
01
—
84450
BLUE CROSS BLUE SHIELD
NC
05
—
8984450
—
NC
Enumeration date
10/24/2006
Last updated
07/08/2007
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