Individual
JERRY D DICKESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
613 23RD ST STE G10, ASHLAND, KY 41101-2886
(064) 085-8646
(606) 408-6499
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-5864
(606) 408-6499
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50.005673
OH
363A00000X
Physician Assistant
Primary
PA2449
KY
Other
Enumeration date
08/02/2018
Last updated
05/24/2022
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