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Organization
MEADOWCREST FAMILY PRACTICE PA
Active
Organization
MEADOWCREST FAMILY PRACTICE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIMMY C DICKERT D.O. (DIRECT OWNER)
(352) 795-0644
Entity
Organization
Contact information
Practice address
5915 W GULF TO LAKE HWY, CRYSTAL RIVER, FL 34429-7565
(352) 795-0644
(352) 795-5950
Mailing address
5915 W GULF TO LAKE HWY, CRYSTAL RIVER, FL 34429-7565
(352) 795-0644
(352) 795-5950
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0958010001
FL
Other
Enumeration date
02/16/2007
Last updated
01/07/2009
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