Healthcare Provider Details

I. General information

NPI: 1831771500
Provider Name (Legal Business Name): JORRIE DYKES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 09/03/2026
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S SANTA FE AVE
SALINA KS
67401-4144
US

IV. Provider business mailing address

400 S SANTA FE AVE
SALINA KS
67401-4144
US

V. Phone/Fax

Practice location:
  • Phone: 785-452-7163
  • Fax: 785-452-6873
Mailing address:
  • Phone: 785-452-7163
  • Fax: 785-452-6873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number04-53644
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number04-53644
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: