Organization
TYSON BIG TREE LLC
Active
Other names
Tyson Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
WESTON HUMPHREYS (COO)
(662) 236-2222
Entity
Organization
Contact information
Practice address
2159 S LAMAR BLVD, OXFORD, MS 38655
(662) 236-2222
Mailing address
2159 S LAMAR BLVD, OXFORD, MS 38655
(662) 236-2222
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
04/17/2024
Last updated
01/09/2025
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