Individual
DR. ROBERT L. DEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1800 12TH ST, MERIDIAN, MS 39301-4158
(601) 703-4282
(601) 703-4597
Mailing address
1800 12TH ST, MERIDIAN, MS 39301-4158
(601) 703-9632
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
17079
MS
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
17079
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123534
—
MS
01
—
009948470
MEDICAID OF AL
AL
01
—
418195297
TRICARE
—
Enumeration date
08/10/2005
Last updated
10/27/2014
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