Individual
REGINALD PEELER DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
300 STEAM PLANT RD, SUITE 300, GALLATIN, TN 37066-3032
(615) 451-9200
(615) 989-4217
Mailing address
501 GREAT CIRCLE RD, SUITE 200, NASHVILLE, TN 37228-1317
(615) 451-9200
(615) 989-4217
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
43777
TN
207RC0001X
Clinical Cardiac Electrophysiology Physician
43777
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1507710
—
TN
01
—
6011931
BCBS
TN
01
—
P00702357
RR MEDICARE
TN
Enumeration date
10/26/2005
Last updated
10/16/2014
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