Organization
TYSON BIG TREE LLC
Active
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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