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Individual

DAVID A DICKINSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
900 N WASHINGTON ST, DU QUOIN, IL 62832-1233
(618) 542-2146
(618) 542-2154
Mailing address
PO BOX 192, DU QUOIN, IL 62832-0192
(618) 542-2146
(618) 542-2514

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016005359
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
016005359
STATE LICENSE
IL
Enumeration date
03/12/2007
Last updated
01/27/2021
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