Individual
KEITH DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1160 PATTERSON RD, GRAND JUNCTION, CO 81506-8275
(970) 298-2800
(970) 298-7522
Mailing address
1160 PATTERSON RD, PO BOX 62, GRAND JUNCTION, CO 81506-8275
(970) 298-2800
(970) 298-7522
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42576
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01470825
—
CO
Enumeration date
12/21/2005
Last updated
04/04/2011
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