Individual
GERALD A DYSERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
23 WILLOW DR, AUXIER, KY 41602-9259
(606) 886-8997
(606) 886-1021
Mailing address
1709 KY ROUTE 321, SUITE 3, PRESTONSBURG, KY 41653-9097
(606) 886-8546
(606) 886-8548
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
34177
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000044263
BCBS PROVIDER NUMBER
—
01
—
34177
LICENSE
KY
05
—
64341779
—
KY
Enumeration date
09/20/2006
Last updated
06/13/2012
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