| Doctor Name: | DR. GEORGE WALTER TYSON |
| NPI Number: | 1013339894 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 153174-1 |
| Business Practice Address: | 25 Highwood Rd Setauket, NY - 117331526 |
| Business Phone Number: | 6316890570 |
| Business Fax Number: | |
| Mailing Address: | 25 Highwood Rd, SETAUKET |
| State: | NY |
| Postal Code: | 117331526 |
| Phone Number: | 6316890570 |
| Fax Number: | |
| NPI Enumeration Date: | 01/13/2014 |
| NPI Last Update Date: | 01/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 202C00000X |
| License Number: | 153174-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Independent Medical Examiner |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A special evaluator not involved with the medical care of the individual examinee that impartially evaluates the care being provided by other practitioners to clarify clinical, disability, liability or other case issues. |