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NPI Code Detail

MEDICARE: DARON DYKEMA MD

MEDICARE: DARON DYKEMA 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
1207Q00000XFamily Medicine Physician6031AK

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 : 1720094220
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARON DYKEMA MD
Provider Business Mailing Address
First Line : PO BOX 4105
Second Line :
City : PORTLAND
State : OR
Zip : 97208-4105
Country : US
Telephone Number : 866-907-1068
Fax Number : 425-917-9141
Provider Business Practice Location Address
First Line : 1201 E 36TH AVE
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-4372
Country : US
Telephone Number : 907-562-9229
Fax Number : 907-561-4806
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2006
Last Update Date : 09/23/2020

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Directions to “ DARON DYKEMA MD” Practice Location

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