Dickson, Douglas J

Dickson, Douglas J is an individual health care provider with primary practice located at 792 N Main St , North Syracuse NY 13212-1644. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Dickson, Douglas J can be contacted via phone (315) 452-4670.

Contact Information

Primary practice address
792 N Main St North Syracuse NY 13212-1644
Phone: (315) 452-4670
Fax: (315) 579-4670
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X N004816 New York

Profile Details

NPI number 1083649008
LBN Legal business name Dickson, Douglas J
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Oct 21st, 2015 - about 11 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 1083649008 NPPES
New York Other 620006599 GHI
New York MEDICAID 01337159 GHI

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