Individual
STEPHEN CHARLES TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1612 MILSTEAD RD NE STE B, CONYERS, GA 30012-3738
(770) 388-7745
(770) 922-0526
Mailing address
4140 ALEXIS CT, LOGANVILLE, GA 30052-9070
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
10610
GA
367H00000X
Anesthesiologist Assistant
—
—
Other
Enumeration date
07/07/2021
Last updated
04/20/2023
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