Provider Demographics
NPI:1740586320
Name:DYKE, STEVEN LYNN JR
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:LYNN
Last Name:DYKE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717B HIGHWAY 70 E
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:OK
Mailing Address - Zip Code:73439-8253
Mailing Address - Country:US
Mailing Address - Phone:580-564-7308
Mailing Address - Fax:580-564-7309
Practice Address - Street 1:717B HIGHWAY 70 E
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:OK
Practice Address - Zip Code:73439-8253
Practice Address - Country:US
Practice Address - Phone:580-564-7308
Practice Address - Fax:580-564-7309
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-31
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator