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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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