Individual
DR. EPHRAIM DICKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
260 HOSPITAL DR STE 107, UKIAH, CA 95482
(707) 467-5278
Mailing address
260 HOSPITAL DR STE 107, UKIAH, CA 95482-4568
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2015-00873
NC
207X00000X
Orthopaedic Surgery Physician
Primary
A121228
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386957785
—
NC
05
—
NC2420
—
SC
Enumeration date
07/15/2010
Last updated
05/22/2018
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