Dickerson, Gregg Alan

Dickerson, Gregg Alan is an sole proprietor health care provider with primary practice located at 1514 E Union St , Greenville MS 38703-3248. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Radiation Oncology. Allopathic & Osteopathic Physicians / Radiation Oncology is his primary health care specialty. Dickerson, Gregg Alan can be contacted via phone (662) 332-6150.

Contact Information

Primary practice address
1514 E Union St Greenville MS 38703-3248
Phone: (662) 332-6150
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 17812 Mississippi
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 47586 Colorado

Profile Details

NPI number 1699777854
LBN Legal business name Dickerson, Gregg Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 1st, 2005
Last updated Nov 30th, 2016 - about 9 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 1699777854 NPPES
Mississippi Other 10781438 UNITEDHEALTHCARE CAQH
Mississippi Other 896610 UNITEDHEALTHCARE CAQH

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