Organization
TYLER HOLMES MEMORIAL HOSPITAL
Active
Parent organization
TYLER HOLMES MEMORIAL HOSPITAL
Other names
Tyler Holmes Carrollton Clinic, Tyler Holmes Carrollton Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
TYLER HOLMES MEMORIAL HOSPITAL
Authorized official
MEMORIE LYONS (CLINIC DIRECTOR)
(662) 283-6119
Entity
Organization
Contact information
Practice address
504 GEORGE STREET, NORTH CARROLLTON, MS 38947
(662) 989-1574
(662) 989-1569
Mailing address
409 TYLER HOLMES DR, WINONA, MS 38967-1521
(662) 283-4114
(662) 283-6125
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000015590
—
MS
05
—
001608351
—
MS
05
—
001709891
—
MS
01
—
1497164446
NPI
MS
01
—
1548883481
NPI
MS
01
—
1568502714
NPI
MS
01
—
1700426707
NPI
MS
05
—
200007660
—
MS
01
—
2466404
WELLCARE
MS
Enumeration date
05/27/2020
Last updated
06/18/2024
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