Individual
TYNES EMERY MIXON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
426 CHARLES ST, NEW IBERIA, LA 70560-3707
(337) 365-4156
(337) 365-4192
Mailing address
426 CHARLES ST, NEW IBERIA, LA 70560-3707
(337) 365-4156
(337) 365-4192
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
020891
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1680095
—
LA
Enumeration date
09/27/2005
Last updated
09/09/2013
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