Dyersburg Surgical Group, Inc.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

1991 Issued in TN

Legal business name

DYERSBURG SURGICAL GROUP, INC.

Practice address

1718 Parr Ave
Suite a
Dyersburg, TN 38024-2071

Phone

(731) 286-0198

Fax

(731) 287-7367

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

Jeffrey Allen Swetnam, M.D.

Title

President

Phone

(731) 286-0198

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609900612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 PARR AVE",
            "address_2": "SUITE A",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242071",
            "telephone_number": "731-286-0198",
            "fax_number": "731-287-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 PARR AVE",
            "address_2": "SUITE A",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242071",
            "telephone_number": "731-286-0198",
            "fax_number": "731-287-7367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYERSBURG SURGICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SWETNAM",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "731-286-0198",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "TN",
            "license": "1991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dyersburg Uniform Shoppe
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• Preferred Provider Organization in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• Preferred Provider Organization in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.