Dickson, Brian Glenn

Dickson, Brian Glenn is an sole proprietor health care provider with primary practice located at 1010 S Main St Ste 200 , Jonesboro AR 72401-3503. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Dickson, Brian Glenn can be contacted via phone (870) 932-1820.

Contact Information

Primary practice address
1010 S Main St Ste 200 Jonesboro AR 72401-3503
Fax: (870) 972-6712
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X E2747 Arkansas

Profile Details

NPI number 1215908710
LBN Legal business name Dickson, Brian Glenn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2006
Last updated May 27th, 2021 - about 4 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 1215908710 NPPES
Missouri Other 1215908710 MISSOURI MEDICAID
Missouri MEDICAID 142999001 MISSOURI MEDICAID
Missouri Other 200041938 MISSOURI MEDICAID

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