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General NPI Number Information
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NPI Number | 1285649855
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Entity Type | Organization
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Legal Business Name | TYLER HOLMES MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 01/29/2024
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Provider Practice Location Address
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Address Line | 700 WOODLAND DRIVE
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City | WINONA
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State | MS
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Zip | 38967
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Country | US
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Telephone | 662-283-3060
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Fax | 662-283-3553
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Provider Business Mailing Address
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Address Line | 409 TYLER HOLMES DRIVE
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City | WINONA
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State | MS
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Zip | 38967
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Country | US
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Telephone | 662-283-4114
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Fax | 662-283-3553
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | MEMORIE LYONS
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Credential |
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Telephone | 662-283-6119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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