Individual
STEPHEN DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19550 E 39TH ST S STE 215, INDEPENDENCE, MO 64057-2326
(816) 461-6837
Mailing address
19550 E 39TH ST S STE 215, INDEPENDENCE, MO 64057-2326
(816) 461-6837
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
583423
TX
207RC0000X
Cardiovascular Disease Physician
04-43656
KS
207RC0000X
Cardiovascular Disease Physician
Primary
2020027326
MO
207RC0000X
Cardiovascular Disease Physician
A149358
CA
Other
Enumeration date
06/13/2014
Last updated
09/08/2020
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