| Douglas Dycus | |
|
3698 S Grundy Quarles Hwy Gainesboro TN 38562-5950 | |
| (931) 268-3224 | |
| (931) 268-3228 |
| Full Name | Douglas Dycus |
|---|---|
| Speciality | Internal Medicine |
| Location | 3698 S Grundy Quarles Hwy, Gainesboro, Tennessee |
| Authorized Official Name and Position | Tammy Dycus (OFFICE MANGER) |
| Authorized Official Contact | 9312683224 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Douglas Dycus Po Box 247 Gainesboro TN 38562-0247 Ph: (931) 268-3224 | Douglas Dycus 3698 S Grundy Quarles Hwy Gainesboro TN 38562-5950 Ph: (931) 268-3224 |
| NPI Number | 1013195106 |
|---|---|
| Provider Enumeration Date | 01/31/2008 |
| Last Update Date | 01/31/2008 |
| Medicare PECOS PAC ID | 7618967175 |
|---|---|
| Medicare Enrollment ID | O20040517000098 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013195106 | NPI | - | NPPES |
| 3371574 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD020847 (Tennessee) | Primary |
| Provider Name | Douglas C Dycus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780601708 PECOS PAC ID: 2062402522 Enrollment ID: I20100823000302 |
| Provider Name | Dolores M Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932536125 PECOS PAC ID: 0648407130 Enrollment ID: I20150311000166 |
Gainesboro Ultimate Med Service Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 179 Buck Branch Ln, Gainesboro, TN 38562 Phone: 931-303-0012 Fax: 931-241-5444 | |
Cookeville Medical Clinic Gainesboro Rhc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 402 E Gore Ave, Gainesboro, TN 38562 Phone: 931-268-6899 Fax: 931-858-8650 |