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Tyson Big Tree LLC

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Company Details

Name: Tyson Big Tree LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 27 Jun 2023 (2 years ago)
Business ID: 1399491
ZIP code: 38655
County: Lafayette
State of Incorporation: MISSISSIPPI
Principal Office Address: 2159 South Lamar Blvd, Suite 100Oxford, MS 38655
Fictitious names: Tyson Medical Clinic

Agent

Name Role Address
Robert Lomenick Agent 2159 South Lamar Blvd, Oxford, MS 38655

Manager

Name Role Address
Robert Lomenick Manager 2159 South Lamar Blvd, Oxford, MS 38655

National Provider Identifier

NPI Number:
1770338410
Certification Date:
2025-01-09

Authorized Person:

Name:
WESTON HUMPHREYS
Role:
COO
Phone:

Taxonomy:

Selected Taxonomy:
208D00000X - General Practice Physician
Is Primary:
No
Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Filings

Type Status Filed Date Description
Annual Report LLC Filed 2025-01-14 Annual Report For Tyson Big Tree LLC
Fictitious Name Registration Filed 2024-10-21 Fictitious Name Registration For Tyson Big Tree LLC
Annual Report LLC Filed 2024-01-24 Annual Report For Tyson Big Tree LLC
Formation Form Filed 2023-06-26 Formation For Tyson Big Tree LLC

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Date of last update: 03 Jun 2025

Sources: Company Profile on Mississippi Secretary of State Website