Dirksen, John Stuart
Dirksen, John Stuart is an sole proprietor health care provider with primary practice located at 104 B Srp Dr , Evans GA 30809-3319. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Dirksen, John Stuart can be contacted via phone (706) 210-8400.Contact Information
Primary practice address
104 B Srp Dr
Evans GA 30809-3319
Phone: (706) 210-8400
Fax: (706) 210-8311
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 033771 | Georgia |
Profile Details
| NPI number | 1679570147 |
|---|---|
| LBN Legal business name | Dirksen, John Stuart |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 30th, 2005 |
| Last updated | Oct 3rd, 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 | 1679570147 | NPPES |
| Georgia | Other | 260048595 | RAILROAD MEDICARE |
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