Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | MD055741L | PA |
NPI | 1013976398 |
---|---|
Provider Name | James B Dickey |
First Address | Pittsburgh, PA 15228-2001 |
Second Address | Pittsburgh, PA 15228-2001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 06/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F39028 | (02) | PA |