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Organization

J KEVIN DICKENSON MD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH KEVIN DICKENSON MD (OWNER)
(304) 894-8211
Entity
Organization

Contact information

Practice address
2401 S KANAWHA ST, SUITE 104, BECKLEY, WV 25801-6967
(304) 894-8211
(304) 894-8213
Mailing address
PO BOX 207, BECKLEY, WV 25802-0207
(304) 894-8211
(304) 894-8213

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
19735
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001759805
BC BS GROUP ID
WV
Enumeration date
10/24/2006
Last updated
04/30/2009
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