Individual
MARK THOMAS DICKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4601 CAROTHERS PKWY, STE 475, FRANKLIN, TN 37067-5980
(615) 790-1660
(615) 790-3705
Mailing address
2801 CHARLOTTE AVE, NASHVILLE, TN 37209-4035
(615) 250-9200
(615) 250-9251
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
A67587
CA
208800000X
Urology Physician
Primary
MD37792
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3886483
—
TN
01
—
4067530
BLUE CROSS
TN
05
—
64069941
—
KY
01
—
P00035782
RR MEDICARE
TN
Enumeration date
12/30/2005
Last updated
02/02/2022
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