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Individual
DR. JOHN THOMAS DICKERSON III
Active
Individual
DR. JOHN THOMAS DICKERSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4980
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000387294
ANTHEM NUMBER
KY
01
—
1226091
CHA NUMBER
KY
01
—
431461126
MEDICAL MUTUAL OF OHIO #
OH
01
—
693259
ACN NUMBER
KY
01
—
7296724
AETNA NUMBER
KY
Enumeration date
11/14/2006
Last updated
06/19/2013
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