# DWAYNE LIKENS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1326336793
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 0102204025 | VA | — |
| 207Q00000X | Family Medicine Physician | 04064 | KY | Yes |
| 207Q00000X | Family Medicine Physician | 2827 | TN | — |

## Other

- **Enumeration date:** 07/19/2011
- **Last updated:** 02/09/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 300032286 | — | IN |
| 05 | — | 7100418380 | — | KY |
| 01 | — | K239373 | MEDICARE | KY |