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Contact Information

SAMUEL L TYSON, MD
3810 N ELM ST
209
GREENSBORO, NC27455
 Phone: 336-282-3940
 Fax: 336-282-8404
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for SAMUEL L TYSON · (Male)

NPI Number 1750327870
Status Active
Credentials MD
Entity Individual
Enumeration date 06/20/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • NC License # 38229
  • NC Medicaid 890257X
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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