Dickson, Clark Bart
Dickson, Clark Bart is an individual health care provider with primary practice located at 29201 Telegraph Rd Suite 500, Southfield MI 48034-1331. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Dickson, Clark Bart can be contacted via phone (248) 569-5985.Contact Information
Primary practice address
29201 Telegraph Rd Suite 500
Southfield MI 48034-1331
Phone: (248) 569-5985
Fax: (248) 569-3704
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | CD046491 | Michigan |
Profile Details
| NPI number | 1770560427 |
|---|---|
| LBN Legal business name | Dickson, Clark Bart |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 23rd, 2005 |
| Last updated | Mar 13th, 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 | 1770560427 | NPPES |
| Michigan | MEDICAID | 3211330 |
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