Dickerson, Sandra Jones

Dickerson, Sandra Jones is an individual health care provider with primary practice located at 5695 Kilrush Ct Se , Mableton GA 30126-5636. She recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as her primary health care specialty. Dickerson, Sandra Jones can be contacted via phone (404) 578-1057.

Contact Information

Primary practice address
5695 Kilrush Ct Se Mableton GA 30126-5636
Phone: (404) 578-1057
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 34869 Georgia

Profile Details

NPI number 1164521985
LBN Legal business name Dickerson, Sandra Jones
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2006
Last updated Apr 21st, 2021 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164521985 NPPES
Georgia MEDICAID 000469675A
Georgia Other 58-1158044

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