# JEFFERSONVILLE FAMILY AND GERIATRIC MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033359542
- **Authorized official:** DR. WILLIAM R. DICKERMAN D.O. (PHYSICIAN/OWNER)
- **Authorized official phone:** (610) 277-9040

## Contact information

- **Practice address:** 190 WEST GERMANTOWN PIKE, SUITE 155, EAST NORRITON, PA 19401-1383
- **Practice address phone:** (610) 277-9040
- **Practice address fax:** (610) 277-7890
- **Mailing address:** 190 W GERMANTOWN PIKE, SUITE 155, EAST NORRITON, PA 19401-1385
- **Mailing address phone:** (610) 277-9040
- **Mailing address fax:** (610) 277-7890

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | OS006150L | PA | Yes |

## Other

- **Enumeration date:** 02/23/2009
- **Last updated:** 07/08/2016