Individual
TYSON LEE CLAIBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4501 MIXON AVE APT 107, NORTH CHARLESTON, SC 29405-5105
(865) 603-2375
Mailing address
4501 MIXON AVE APT 107, NORTH CHARLESTON, SC 29405-5105
(865) 603-2375
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/19/2020
Last updated
06/10/2025
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