Dickenson, Russell Eric

Dickenson, Russell Eric is an individual health care provider with primary practice located at 10800 Parkside Dr Ste 331 , Knoxville TN 37934-1922. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Dickenson, Russell Eric can be contacted via phone (865) 392-3400.

Contact Information

Primary practice address

10800 Parkside Dr Ste 331 Knoxville TN 37934-1922

Phone: (865) 392-3400

Fax: (865) 392-3449

Website:

Map and Directions

Health care specialties

Specialty	Code	License #	State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant	363A00000X	100	Tennessee

Profile Details

NPI number	1497745814
LBN Legal business name	Dickenson, Russell Eric
Credentials	Physician's Assistant Certified (PA-C)
Entity	Individual
Sole proprietor ¹	No
Enumeration date	Oct 26th, 2005
Last updated	Sep 14th, 2020 - about 5 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

State	Type	Number	Issuer
All States	NPI	1497745814	NPPES
Tennessee	MEDICAID	3665210

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