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Organization

DOUGLAS DYCUS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. TAMMY DYCUS (OFFICE MANGER)
(931) 268-3224
Entity
Organization

Contact information

Practice address
3698 S GRUNDY QUARLES HWY, GAINESBORO, TN 38562-5950
(931) 268-3224
(931) 268-3228
Mailing address
PO BOX 247, GAINESBORO, TN 38562-0247
(931) 268-3224
(931) 268-3228

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD020847
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3371574
TN
Enumeration date
01/31/2008
Last updated
01/31/2008
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