Provider Demographics
NPI:1245872969
Name:DYKES, DOWNER PACE III (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DOWNER
Middle Name:PACE
Last Name:DYKES
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 9TH AVE W
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-2529
Mailing Address - Country:US
Mailing Address - Phone:214-564-3386
Mailing Address - Fax:
Practice Address - Street 1:202 9TH AVE W
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-2529
Practice Address - Country:US
Practice Address - Phone:214-564-3386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP00117371835G0303X, 1835P0018X, 1835P2201X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care