Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 9291183-1204 | UT |
N | 208000000X | Pediatrician | 02003323A | IN |
N | 208000000X | Pediatrician | 58.002130 | OH |
NPI | 1467576322 |
---|---|
Provider Name | Scott D Dickson |
First Address | Logan, UT 84341-2400 |
Second Address | Logan, UT 84341-2400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2007 |
Last Update Date | 08/09/2021 |