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Individual

ERIC LEE DYCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2102 BAPTISTE DR, PAOLA, KS 66071-1314
(913) 557-5678
(913) 557-5681
Mailing address
2102 BAPTISTE DR, PAOLA, KS 66071-1314
(913) 557-5678
(913) 557-5681

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0418590
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100420290A
KS
Enumeration date
05/18/2006
Last updated
10/18/2013
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