Provider Demographics
NPI:1922582345
Name:DYCUS, BILLY JR (NP)
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:
Last Name:DYCUS
Suffix:JR
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8737 HIGHWAY 613
Mailing Address - Street 2:
Mailing Address - City:MOSS POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39562-8179
Mailing Address - Country:US
Mailing Address - Phone:228-497-2652
Mailing Address - Fax:
Practice Address - Street 1:3300 LADNIER RD
Practice Address - Street 2:
Practice Address - City:GAUTIER
Practice Address - State:MS
Practice Address - Zip Code:39553-5909
Practice Address - Country:US
Practice Address - Phone:228-497-2652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902741363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily