NPI Code Details Logo

NPI 1225713407

NPI 1225713407 : MEGAN DYKEMA DPT : FAYETTEVILLE, AR

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1225713407
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    MEGAN DYKEMA DPT
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/16/2023
-----------------------------------------------------
    Last Update Date     |    05/21/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1125 N COLLEGE AVE 
-----------------------------------------------------
    City                 |    FAYETTEVILLE
-----------------------------------------------------
    State                |    AR
-----------------------------------------------------
    Zip                  |    72703-1908
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    479-713-8630
-----------------------------------------------------
    Fax                  |    479-713-8639
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    4301 W MARKHAM ST # 783 
-----------------------------------------------------
    City                 |    LITTLE ROCK
-----------------------------------------------------
    State                |    AR
-----------------------------------------------------
    Zip                  |    72205-7101
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    501-686-8000
-----------------------------------------------------
    Fax                  |    501-526-5148
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    225100000X
-----------------------------------------------------
    Taxonomy Name        |    Physical Therapist
-----------------------------------------------------
    License Number       |    PT-5122
-----------------------------------------------------
    License Number State |    AR
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.