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NPI Code Detail

MEDICARE: MICHAEL D DYKES MD

MEDICARE: MICHAEL D DYKES MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician059148GA
2208VP0000XPain Medicine Physician0000026586TN
3208VP0014XInterventional Pain Medicine Physician05BDLQKGA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164456240
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL D DYKES MD
Provider Business Mailing Address
First Line : 460 MALL BLVD STE B
Second Line :
City : SAVANNAH
State : GA
Zip : 31406-4891
Country : US
Telephone Number : 912-644-5300
Fax Number : 706-378-1204
Provider Business Practice Location Address
First Line : 1601 FAIR RD STE 800
Second Line :
City : STATESBORO
State : GA
Zip : 30458-0800
Country : US
Telephone Number : 800-827-6536
Fax Number : 912-644-5260
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 07/22/2022

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