Physician Compare National (NPI:1861474827)

HEALTHCARE PROVIDER: PAUL G DYKES MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1861474827
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8325130750
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101013000434
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DYKES
	Individual professional last name
Provider First Name	PAUL
	Individual professional first name
Provider Middle Name	GERRIT
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	NEPHROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	101 MILLS ST
	Group Practice or individual's line 1 address
City	BROOKHAVEN
	Group Practice or individual's city
State	MS
	Group Practice or individual's state
Zip Code	396012521
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	250057
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	KING'S DAUGHTERS MEDICAL CENTER-BROOKHAVEN
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	250097
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SOUTHWEST MS REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	251309
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	FIELD HEALTH SYSTEM
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	251305
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	LAWRENCE COUNTY HOSPITAL CAH
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y