Garrett McTyre Minor
Student in an Organized Health Care Education/Training Program in Jackson, MS. Individual provider (NPI-1).
NPI number1114555000
StatusActive
Last updated in NPPESJul 29, 2026
Details
- NPI
- 1114555000
- Entity type
- Individual (NPI-1)
- Name
- Garrett McTyre Minor
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 28, 2020
- Certification date
- Jul 29, 2026
- Last updated
- Jul 29, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | T6168 | MS | Yes |
Practice location
2500 N State StJackson, MS 39216-4500
Phone 601-984-1000
Mailing address
120 District Blvd Apt 416Jackson, MS 39211-6388
Phone 731-693-0932
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