Individual
DR. JEFFREY DOUGLAS DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4301 W MARKHAM ST, LITTLE ROCK, AR 72205-7101
(501) 686-6337
Mailing address
1801 CHAMPLIN DR APT 1208, LITTLE ROCK, AR 72223-3980
(501) 821-1780
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101242576
VA
207P00000X
Emergency Medicine Physician
390200000X
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12766671
CAQH
VA
Enumeration date
05/24/2007
Last updated
11/26/2014
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