Individual
JONATHAN DAVID DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1444 E STEARNS ST STE 11, FAYETTEVILLE, AR 72703-4969
(479) 718-7546
Mailing address
1444 E STEARNS ST STE 11, FAYETTEVILLE, AR 72703-4969
(479) 718-7546
(479) 966-4979
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1154
AR
363A00000X
Physician Assistant
PA13777
TX
Other
Enumeration date
02/14/2019
Last updated
05/01/2023
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