Dickerson, Russell S
Dickerson, Russell S is an sole proprietor health care provider with primary practice located at 1680 Antilley Rd Ste 250 , Abilene TX 79606-5247. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Dickerson, Russell S can be contacted via phone (325) 698-1100.Contact Information
Primary practice address
1680 Antilley Rd Ste 250
Abilene TX 79606-5247
Phone: (325) 698-1100
Fax: (325) 698-1108
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | J1517 | Texas |
Profile Details
| NPI number | 1821215237 |
|---|---|
| LBN Legal business name | Dickerson, Russell S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 19th, 2007 |
| Last updated | Feb 28th, 2019 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821215237 | NPPES |
| Texas | MEDICAID | 125311405 |
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