Individual
JOEL R DICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6119 MIDTOWN AVE, LITTLE ROCK, AR 72205-5313
(501) 296-1800
(501) 296-1711
Mailing address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-5148
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
52801
CO
207V00000X
Obstetrics & Gynecology Physician
Primary
E-15045
AR
207V00000X
Obstetrics & Gynecology Physician
J1516
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118592805
—
TX
01
—
8P1409
BLUE CROSS
TX
Enumeration date
04/06/2006
Last updated
06/29/2022
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