Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 22282 | AL |
NPI | 1023086022 |
---|---|
Provider Name | Daryl Glenn Dykes |
First Address | Pelham, AL 35124-5826 |
Second Address | Pelham, AL 35124-5826 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 28/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G85793 | (02) |