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Organization
DICKSON ORTHOPEDICS, P.A.
Active
Organization
DICKSON ORTHOPEDICS, P.A.
Active
Other names
Jonesboro Orthopedics and Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
KACEY LYNN DAVIS (OFFICE MANAGER)
(870) 932-1820
Entity
Organization
Contact information
Practice address
1010 S MAIN ST, JONESBORO, AR 72401-3503
(870) 932-1820
(870) 972-6712
Mailing address
1010 S MAIN ST, JONESBORO, AR 72401-3503
(870) 932-1820
(870) 972-6712
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MC0874
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129705002
—
AR
05
—
232042748
—
AR
01
—
CE8064
RAILROAD MEDICARE
AR
Enumeration date
02/22/2006
Last updated
09/01/2023
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