Dickson, Clark Bart

Dickson, Clark Bart is an individual health care provider with primary practice located at 29201 Telegraph Rd Suite 500, Southfield MI 48034-1331. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Dickson, Clark Bart can be contacted via phone (248) 569-5985.

Contact Information

Primary practice address
29201 Telegraph Rd Suite 500 Southfield MI 48034-1331
Phone: (248) 569-5985
Fax: (248) 569-3704
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X CD046491 Michigan

Profile Details

NPI number 1770560427
LBN Legal business name Dickson, Clark Bart
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 23rd, 2005
Last updated Mar 13th, 2012 - about 13 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 1770560427 NPPES
Michigan MEDICAID 3211330

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