Organization
DANVILLE PEDIATRICS AND PRIMARY CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY DICKINSON M.D. (MEDICAL DIRECTOR)
(859) 236-1080
Entity
Organization
Contact information
Practice address
303 S 4TH ST, DANVILLE, KY 40422-2004
(859) 236-1080
(859) 236-1862
Mailing address
303 S 4TH ST, DANVILLE, KY 40422-2004
(859) 236-1080
(859) 236-1862
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100000530
—
KY
Enumeration date
08/21/2006
Last updated
10/07/2021
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