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Individual

DR. DAVID P DICKERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D. C.

Contact information

Practice address
3705 N HARRISON ST, SHAWNEE, OK 74804-2223
(405) 273-6822
(888) 413-2901
Mailing address
3705 N HARRISON ST, SHAWNEE, OK 74804-2223
(405) 273-6822
(888) 413-2901

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2916
CO
111N00000X
Chiropractor
Primary
4127
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C26033
MEDICARE LEGACY
CO
Enumeration date
12/29/2006
Last updated
04/14/2021
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