Dickerson, Jill B
Dickerson, Jill B is an sole proprietor health care provider with primary practice located at 10 Market Square Way Ste 100 , Newnan GA 30265-6078. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Dickerson, Jill B can be contacted via phone (678) 423-5560.Contact Information
Primary practice address
10 Market Square Way Ste 100
Newnan GA 30265-6078
Phone: (678) 423-5560
Fax: (678) 423-5563
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 061061 | Georgia |
Profile Details
| NPI number | 1497714257 |
|---|---|
| LBN Legal business name | Dickerson, Jill B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 21st, 2006 |
| Last updated | Oct 22nd, 2012 - about 14 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 | 1497714257 | NPPES |
| Georgia | MEDICAID | 182611684A |
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