Individual
DR. BRIAN GLENN DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1010 S MAIN ST STE 200, JONESBORO, AR 72401-3503
(870) 932-1820
(870) 972-6712
Mailing address
1010 S MAIN ST STE 200, JONESBORO, AR 72401-3503
(870) 932-1820
(870) 972-6712
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
E2747
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215908710
MISSOURI MEDICAID
MO
05
—
142999001
—
AR
01
—
200041938
RAILROAD MEDICARE
AR
Enumeration date
02/01/2006
Last updated
05/27/2021
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