Individual
DR. DOUGLAS J DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
792 N MAIN ST, NORTH SYRACUSE, NY 13212-1644
(315) 452-4670
(315) 579-4670
Mailing address
792 N MAIN ST, NORTH SYRACUSE, NY 13212-1644
(315) 452-4670
(315) 579-4670
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N004816
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01337159
—
NY
01
—
620006599
GHI
NY
Enumeration date
07/11/2006
Last updated
10/21/2015
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