Individual
DR. JAMES MALCOLM DYESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12 WESTBANK EXPY, GRETNA, LA 70053-3647
(504) 368-3100
(504) 368-0555
Mailing address
100 MERGANSER DR, MANDEVILLE, LA 70448-6607
(985) 951-8941
(986) 951-8943
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
023074
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
721469018
TAX #
LA
Enumeration date
09/13/2006
Last updated
10/22/2008
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