Individual
DR. MATTHEW R DICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 AINSWORTH DR, SUITE 115, PRESCOTT, AZ 86305-1667
(928) 778-1971
(928) 443-8473
Mailing address
1000 AINSWORTH DR, SUITE 115, PRESCOTT, AZ 86305-1667
(928) 778-1971
(928) 443-8473
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
33711
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
945040
—
AZ
Enumeration date
09/23/2005
Last updated
07/25/2011
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