Dickens, Mario S.

Dickens, Mario S. is an sole proprietor health care provider with primary practice located at 6116 Shallowford Rd Ste 118, Chattanooga TN 37421-7201. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Dickens, Mario S. can be contacted via phone (423) 710-1224.

Contact Information

Primary practice address
6116 Shallowford Rd Ste 118 Chattanooga TN 37421-7201
Phone: (423) 710-1224
Fax: (423) 710-1228
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 690 Tennessee

Profile Details

NPI number 1902843154
LBN Legal business name Dickens, Mario S.
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 31st, 2006
Last updated Mar 11th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902843154 NPPES
Michigan MEDICAID 4342355
Michigan Other P00744501
Michigan MEDICAID 1512827

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