Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | DO1635 | TN |
NPI | 1215930466 |
---|---|
Provider Name | Dr. Juan S Dinkins |
First Address | Dickson, TN 37055-2850 |
Second Address | Dickson, TN 37055-2850 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 02/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3114072 | (05) | TN |
4096537 | BLUE CROSS BLUE SHIELD TN (01) | TN |
H83675 | (02) | |
P00203737 | RAILROAD MEDICARE PIN (01) |