Individual
KRISTI S. DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8326 NAAB RD, INDIANAPOLIS, IN 46260-1920
(317) 871-0000
(317) 871-0010
Mailing address
8326 NAAB RD, INDIANAPOLIS, IN 46260-1920
(317) 871-0000
(317) 871-0010
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01058422A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200138140
—
IN
05
—
200311740F
—
IN
01
—
320299
ANTHEM PIN#
IN
01
—
4675512
AETNA PIN#
IN
01
—
P00174999
MEDICARE RAILROAD #
IN
Enumeration date
08/15/2005
Last updated
08/13/2024
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