The Family Physician Group PC

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

3926223 Issued in TN

Legal business name

THE FAMILY PHYSICIAN GROUP PC

Doing business as

Herman Wesley Dykes Jr DO

Practice address

7685 Winchester Rd Ste 101
Memphis, TN 38125-2202

Phone

(901) 260-9300

Fax

(901) 751-5541

NPI assigned

Jul 14, 2006

Last updated

Nov 19, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Angie Qualls

Title

Administrator

Phone

(901) 751-5514

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• HERMAN WESLEY DYKES JR DO Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195430400000",
    "number": "1073539938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2859 VAN LEER DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381334935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7685 WINCHESTER RD STE 101",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381252202",
            "telephone_number": "901-260-9300",
            "fax_number": "901-751-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FAMILY PHYSICIAN GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-11-19",
        "status": "A",
        "authorized_official_last_name": "QUALLS",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "901-751-5514"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "TN",
            "license": "3926223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4439154",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "4439154",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HERMAN WESLEY DYKES JR DO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Non-Pharmacy Dispensing Site in Memphis, TN
• Providers in Memphis, TN by specialty
• Non-Pharmacy Dispensing Site in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.