Individual
JORDAN KYLE DICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAA
Contact information
Practice address
1000 JOHNSON FERRY RD, SANDY SPRINGS, GA 30342-1611
(404) 851-8000
Mailing address
4420 PEACHTREE RD NE APT 2426, BROOKHAVEN, GA 30319-2895
(912) 294-0854
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
26626391
GA
Other
Enumeration date
08/10/2018
Last updated
08/10/2018
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