Individual
SAMUEL LESTER TYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3810 N ELM ST, 209, GREENSBORO, NC 27455
(336) 282-3940
(336) 282-8404
Mailing address
3810 N ELM ST, 209, GREENSBORO, NC 27455
(336) 282-3940
(336) 282-8404
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
38229
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890257X
—
NC
Enumeration date
06/20/2006
Last updated
07/08/2007
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