Organization
DICKEN PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT A DICKEN (PRESIDENT)
(218) 681-3300
Entity
Organization
Contact information
Practice address
1720 HIGHWAY 59 SOUTHEAST, SUITE 1, THIEF RIVER FALLS, MN 56701-0505
(218) 681-3300
(218) 681-6733
Mailing address
1720 HIGHWAY 59 SOUTHEAST, SUITE 1, THIEF RIVER FALLS, MN 56701-0505
(218) 681-3300
(218) 681-6733
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0824440
MEDICA
—
01
—
17986
HEALTH PARTNERS
—
01
—
880931027628
PREFERRED ONE
—
Enumeration date
11/16/2006
Last updated
08/22/2020
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