Individual
SPENCER DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1314 19TH AVE, MERIDIAN, MS 39301-4116
(601) 703-9687
(601) 703-9920
Mailing address
PO BOX 5183, MERIDIAN, MS 39302-5183
(601) 703-4282
(601) 703-4597
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
888420
MS
Other
Enumeration date
12/29/2015
Last updated
12/30/2015
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