Individual
RUSSELL S DICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1680 ANTILLEY RD STE 250, ABILENE, TX 79606-5247
(325) 698-1100
(325) 698-1108
Mailing address
1680 ANTILLEY RD STE 250, ABILENE, TX 79606-5247
(325) 698-1100
(325) 698-1108
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
J1517
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125311405
—
TX
Enumeration date
04/19/2007
Last updated
02/28/2019
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