| Organization Name: | DEBORAH L DYKEMA DO PC |
| NPI Number: | 1003181314 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBORAH L DYKEMA (PHYSICIAN OWNER) |
| Mailing Address: | 4025 W Bell Rd Ste 2 Phoenix |
| State: | AZ US |
| Postal Code: | 850532748 |
| Phone Number: | 6029781555 |
| Fax Number: | |
| NPI Enumeration Date: | 03/20/2012 |
| NPI Last Update Date: | 03/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | DO1865 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |