# RYAN D DICKERSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1912921784
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 200880 | LA | Yes |

## Other

- **Enumeration date:** 07/26/2006
- **Last updated:** 09/27/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 200880 | LA MEDICAL LICENSE | LA |
| 01 | — | M2605 | TX MEDICAL LICENSE | TX |