Individual
DR. ANDREW TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3837
(423) 224-3629
(423) 224-4698
Mailing address
509 MED TECH PKWY STE 100, JOHNSON CITY, TN 37604-2579
(423) 302-6565
(423) 952-2175
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
62080
TN
208M00000X
Hospitalist Physician
Primary
62080
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2017
Last updated
12/29/2020
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