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General NPI Number Information
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NPI Number | 1164456240
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Entity Type | Individual
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Provider Name | MICHAEL D DYKES MD
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 07/22/2022
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Provider Practice Location Address
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Address Line | 1601 FAIR RD STE 800
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City | STATESBORO
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State | GA
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Zip | 30458-0800
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Country | US
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Telephone | 800-827-6536
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Fax | 912-644-5260
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Provider Business Mailing Address
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Address Line | 460 MALL BLVD STE B
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City | SAVANNAH
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State | GA
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Zip | 31406-4891
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Country | US
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Telephone | 912-644-5300
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Fax | 706-378-1204
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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 | 059148
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 0000026586
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 05BDLQK
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License Number State | GA
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