Dickerson, Quinton Howard
Dickerson, Quinton Howard is an individual health care provider with primary practice located at 970 Lakeland Dr Suite 61, Jackson MS 39216-4635. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Dickerson, Quinton Howard can be contacted via phone (601) 982-7850.Contact Information
Primary practice address
970 Lakeland Dr Suite 61
Jackson MS 39216-4635
Phone: (601) 982-7850
Fax: (601) 718-5145
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 5261 | Mississippi |
Profile Details
| NPI number | 1942243712 |
|---|---|
| LBN Legal business name | Dickerson, Quinton Howard |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2006 |
| Last updated | Feb 2nd, 2010 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942243712 | NPPES |
| Mississippi | MEDICAID | 00014082 |
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