Individual
TIMOTHY C. DYKSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 SAINT JOSEPH DR, CENTERVILLE, IA 52544-9017
(641) 437-4111
Mailing address
PO BOX 677075, DALLAS, TX 75267-7075
(641) 437-3483
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
31362
IA
207P00000X
Emergency Medicine Physician
MD-31362
IA
207Q00000X
Family Medicine Physician
31362
IA
207Q00000X
Family Medicine Physician
Primary
MD-31362
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043206113
NPI
IA
01
—
56091003
MEDICARE PTAN
IA
Enumeration date
09/23/2005
Last updated
12/21/2025
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