Provider Demographics
NPI:1952007247
Name:DYKES, THOMAS ISAAC (DPT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ISAAC
Last Name:DYKES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E MORRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-2499
Mailing Address - Country:US
Mailing Address - Phone:423-586-6866
Mailing Address - Fax:423-581-9679
Practice Address - Street 1:1526 BRIDGEWATER LN
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-4106
Practice Address - Country:US
Practice Address - Phone:423-586-6866
Practice Address - Fax:423-581-9679
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14797225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist