Individual
KRISTIE DICKESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1480 CARTER AVE, ASHLAND, KY 41101-7546
(606) 329-1890
Mailing address
1480 CARTER AVE, ASHLAND, KY 41101-7546
(606) 329-1890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
011465
OH
207Q00000X
Family Medicine Physician
Primary
03739
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/28/2011
Last updated
01/02/2020
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