Dickinson, Timothy Dale
Dickinson, Timothy Dale is an individual health care provider with primary practice located at 1 Medical Village Dr , Edgewood KY 41017-3403. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Dickinson, Timothy Dale can be contacted via phone (859) 341-7246.Contact Information
Primary practice address
1 Medical Village Dr
Edgewood KY 41017-3403
Phone: (859) 341-7246
Fax: (859) 341-7867
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 38335 | Kentucky |
Profile Details
| NPI number | 1255314423 |
|---|---|
| LBN Legal business name | Dickinson, Timothy Dale |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 22nd, 2005 |
| Last updated | Oct 31st, 2013 - about 13 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 | 1255314423 | NPPES |
| Other | 10902391 | CAQH | |
| Other | 611077369 | CAQH | |
| Other | 7580059 | CAQH | |
| Other | 000000311761 | CAQH | |
| MEDICAID | 200282600 | CAQH | |
| MEDICAID | 0310694 | CAQH | |
| MEDICAID | 64074628 | CAQH |
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