Provider Demographics
NPI:1801781042
Name:TYUS, WILLIAM DAVIS (FNP)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DAVIS
Last Name:TYUS
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 CHARLES COR
Mailing Address - Street 2:
Mailing Address - City:MEXICO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32456-0201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:832 E SHOTWELL ST
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39819-4146
Practice Address - Country:US
Practice Address - Phone:229-234-6146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9464435163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care MedicineGroup - Single Specialty