Dickenson, Stacey D
Dickenson, Stacey D is an individual health care provider with primary practice located at 252 Rural Acres Dr , Beckley WV 25801-3503. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Dickenson, Stacey D can be contacted via phone (304) 252-8551.Contact Information
Primary practice address
252 Rural Acres Dr
Beckley WV 25801-3503
Phone: (304) 252-8551
Fax: (304) 252-1790
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 20007 | West Virginia |
Profile Details
| NPI number | 1700978319 |
|---|---|
| LBN Legal business name | Dickenson, Stacey D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 29th, 2006 |
| Last updated | Jul 17th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700978319 | NPPES |
| Other | G21540 | HEALTH NET | |
| MEDICAID | 54504 | HEALTH NET | |
| MEDICAID | 6700460000 | HEALTH NET | |
| Other | 2136163 | HEALTH NET | |
| Other | 323741 | HEALTH NET | |
| MEDICAID | 58599 | HEALTH NET |
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