Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 24603 | AZ |
NPI | 1568669265 |
---|---|
Provider Name | James Wendell Tyson |
First Address | Tucson, AZ 85742-8735 |
Second Address | Tucson, AZ 85742-8735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2007 |
Last Update Date | 08/07/2007 |