Provider Demographics
NPI:1699732685
Name:MCBAYNE, TYRONE O (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TYRONE
Middle Name:O
Last Name:MCBAYNE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 DENMARK CT
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-4563
Mailing Address - Country:US
Mailing Address - Phone:504-520-5333
Mailing Address - Fax:
Practice Address - Street 1:1 DREXEL DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-1056
Practice Address - Country:US
Practice Address - Phone:504-520-5333
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17289183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist