Individual
DR. TIMOTHY JAMES DICKASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1125 BARTOW RD, STE 101, LAKELAND, FL 33801-5852
(863) 683-7171
Mailing address
1125 BARTOW RD STE 101A, LAKELAND, FL 33801-5845
(281) 221-1823
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
101101
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
101101
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
M7144
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000658200
—
FL
Enumeration date
03/09/2006
Last updated
11/11/2010
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