Organization
DYKES MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL GERRIT DYKES MD (SOLE MEMBER)
(601) 695-9464
Entity
Organization
Contact information
Practice address
101 MILLS ST, BROOKHAVEN, MS 39601-2521
(601) 833-5608
(601) 823-6777
Mailing address
102 LOBLOLLY LN NE, BROOKHAVEN, MS 39601-9217
(601) 695-9464
(601) 823-6777
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MS15940
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124038
—
MS
Enumeration date
01/02/2018
Last updated
05/02/2018
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