Individual
HAL S DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1508 W WHITE RIVER BLVD, MUNCIE, IN 47303-4949
(765) 288-6828
(765) 741-3979
Mailing address
1508 W WHITE RIVER BLVD, MUNCIE, IN 47303-4949
(765) 288-6828
(765) 741-3979
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01041561A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1100202173
ANTHEM PTAN
IN
05
—
200136610A
—
IN
01
—
224040210
MEDICARE PTAN
IN
Enumeration date
12/13/2005
Last updated
06/04/2024
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