Provider Demographics
NPI:1508175738
Name:DCS INSTANT CARE CLINIC INC.
Entity Type:Organization
Organization Name:DCS INSTANT CARE CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:JOESPH
Authorized Official - Last Name:DYESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-799-3480
Mailing Address - Street 1:3300 HIGHWAY 11 N STE C
Mailing Address - Street 2:
Mailing Address - City:PICAYUNE
Mailing Address - State:MS
Mailing Address - Zip Code:39466-2000
Mailing Address - Country:US
Mailing Address - Phone:601-799-3480
Mailing Address - Fax:601-799-3481
Practice Address - Street 1:3300 HIGHWAY 11 N STE C
Practice Address - Street 2:
Practice Address - City:PICAYUNE
Practice Address - State:MS
Practice Address - Zip Code:39466-2000
Practice Address - Country:US
Practice Address - Phone:601-799-3480
Practice Address - Fax:601-799-3481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-05
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20164207Q00000X
261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty