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Export Provider Record NPI 1063509719
Marshall Scott TynesDO
Active
NPI Number1063509719
NPI TypeNPI-1 Individual
SpecialtyFamily Medicine
Provider Details
NPI1063509719
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2006-10-06
Last Updated2024-10-28
Mailing AddressPo Box 749215
Atlanta, GA 30374-9215
United States
Phone: (901) 226-3186
📍 View Map
Primary Practice Address1600 22nd Ave, Medical Towers Iii
Meridian, MS 39301-3223
United States
Phone: (601) 483-5322 | Fax: (601) 581-2289
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)AL009700450ALMCD
MEDICAIDMS0117444
Other (non-Medicare)AL073075294TYNAL BCBS
Other (non-Medicare)279588Tricare
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
Yes207Q00000X – Family MedicineMS14897
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About NPI 1063509719

Marshall Scott Tynes DO is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1063509719. The primary specialty listed is Family Medicine. The provider is located in Meridian, MS. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-10-06. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1063509719?

NPI 1063509719 belongs to Marshall Scott Tynes DO, a Family Medicine in Meridian, MS. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1063509719 active?

The current status of NPI 1063509719 in the NPPES registry is Active. The record was last updated on 2024-10-28.

What specialty is NPI 1063509719?

NPI 1063509719 is classified under the taxonomy Family Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1063509719?

You can verify NPI 1063509719 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1063509719?

The primary practice address on file for NPI 1063509719 is 1600 22nd Ave, Meridian, MS 39301-3223. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1063509719 issued?

NPI 1063509719 was first issued (enumerated) on 2006-10-06. The NPPES record was last updated on 2024-10-28.

Practice Location Map

Marshall Scott Tynes is located at 1600 22nd Ave, Meridian, MS. Use the map below to find directions or verify the practice location.

📍 1600 22nd Ave, Meridian, MS 39301-3223  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Marshall Scott Tynes. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1063509719. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Family Medicine14897MS
Data Verified from CMS NPPES Last synced: 2026-06-17 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162