Individual
THOMAS DYKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 S JACKSON ST # C07, LOUISVILLE, KY 40202-1675
(502) 852-5875
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0330
(915) 545-6607
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
J1653
TX
2085R0202X
Diagnostic Radiology Physician
MD426233
PA
2085R0202X
Diagnostic Radiology Physician
Primary
TP350
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013538120001
—
PA
01
—
J1653
TX MEDICAL LICENSE - TMB
TX
Enumeration date
05/01/2006
Last updated
08/27/2024
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