Dyess, Derek S

Dyess, Derek S is an individual health care provider with primary practice located at 1860 Chadwick Dr Suite B, Jackson MS 39204-3463. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Dyess, Derek S can be contacted via phone (601) 373-6441.

Contact Information

Primary practice address
1860 Chadwick Dr Suite B Jackson MS 39204-3463
Phone: (601) 373-6441
Fax: (601) 373-5715
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 329611 Louisiana
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 042.0016510-COMP Vermont
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 17131 Mississippi

Profile Details

NPI number 1184621021
LBN Legal business name Dyess, Derek S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Aug 24th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184621021 NPPES
Mississippi MEDICAID 07804294
Mississippi Other P00122992

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