Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | E13375 | AR |
Y | 208600000X | Surgeon | E13375 | AR |
NPI | 1013396852 |
---|---|
Provider Name | Dr. Joshua Dickinson |
First Address | Conway, AR 72034-9687 |
Second Address | Conway, AR 72034-4980 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2015 |
Last Update Date | 03/12/2020 |