Healthcare Provider Details

I. General information

NPI: 1922582345
Provider Name (Legal Business Name): BILLY DYCUS JR. NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2018
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8737 HIGHWAY 613 STE 2B
MOSS POINT MS
39562-8179
US

IV. Provider business mailing address

8737 HIGHWAY 613
MOSS POINT MS
39562-8179
US

V. Phone/Fax

Practice location:
  • Phone: 228-246-9800
  • Fax: 470-237-0574
Mailing address:
  • Phone: 228-246-9800
  • Fax: 470-237-0574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number902741
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: