Individual
JEFFREY CLAYTON DICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4010 W 65TH ST, EDINA, MN 55435-1706
(952) 456-7000
(952) 456-7001
Mailing address
4200 DAHLBERG DR STE 300, GOLDEN VALLEY, MN 55422-4841
(952) 512-5600
(952) 512-5650
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
32128
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102891E948
UCARE
—
05
—
699363000
—
MN
01
—
73B07DI
BLUE CROSS BLUE SHIELD
—
01
—
911931
MEDICA
—
01
—
969991000407
PREFERREDONE
—
01
—
HP13159
HEALTHPARTNERS
—
Enumeration date
08/24/2006
Last updated
07/21/2022
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