Individual
MARK S DICKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
13190 OWENS WAY, ALPHARETTA, GA 30004-7357
(404) 218-4912
(770) 872-7463
Mailing address
13190 OWENS WAY, ALPHARETTA, GA 30004-7357
(404) 218-4912
(770) 872-7463
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
001046
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000313046A
—
GA
05
—
000313046B
—
GA
Enumeration date
11/02/2006
Last updated
03/11/2013
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