Diagnostic Tissue/Cytology Group, PLLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

25D0651894 Issued in MS

Legal business name

DIAGNOSTIC TISSUE/CYTOLOGY GROUP, PLLC

Practice address

1512 20TH Ave
Meridian, MS 39301-4124

Phone

(601) 483-8300

Fax

(601) 484-7776

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Brian L. Wilkinson, M.D.NPI 1942300959

Title

Pathologist

Phone

(601) 553-6809

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Tax ID family

Diagnostic Tissuecytology Group PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Diagnostic Tissue/Cytology Group, PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Meridian, MS
  • NPI 1013656602
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian L Wilkinson

  • Anatomic Pathology & Clinical Pathology Physician
  • Meridian, MS
  • NPI 1942300959
  Authorized official Same address or phone
• William A. Wesche, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Shreveport, LA
  • NPI 1174511653
  NPD

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579478400000",
    "number": "1659482529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3780",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388033780",
            "telephone_number": "601-483-8300",
            "fax_number": "601-484-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 20TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014124",
            "telephone_number": "601-483-8300",
            "fax_number": "601-484-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC TISSUE/CYTOLOGY GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PATHOLOGIST",
        "authorized_official_telephone_number": "601-553-6809",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MS",
            "license": "25D0651894",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MS",
            "license": "25D1011258",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MS",
            "license": "25D0980061",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MS",
            "license": "25D0318506",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00132040",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07478777",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "690000005",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dermatology and Skin Cancer Center PLLC
• Dermatology Center of Meridian PA
• Lasherish Derrick
• Diabetic Warehouse, LLC
• Diagnostic Tissue/Cytology Group, PLLC
• Michelle Gomez Dickerson, PMHNP
• Spencer Dickerson, CRNA
• Dean Philip Dickinson, PA
• Sharon Diedrichsen, CNM
• Micah Deon Diener

• Clinical Medical Laboratory in Meridian, MS
• Providers in Meridian, MS by specialty
• Clinical Medical Laboratory in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.