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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083649008 | NPPES |
| New York | Other | 620006599 | GHI |
| New York | MEDICAID | 01337159 | GHI |
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