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General NPI Number Information
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NPI Number | 1063613727
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Entity Type | Individual
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Provider Name | MICHAEL JOSEPH DYMOND MD
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Gender | Male
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 3601 4TH ST STOP 6238
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City | LUBBOCK
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State | TX
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Zip | 79430-3268
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Country | US
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Telephone | 806-743-4263
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Fax |
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4959
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 4301097710
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 246928-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 042.0013037
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License Number State | VT
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 01079496A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | V4228
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License Number State | TX
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