Dickson, Dane J
Dickson, Dane J is an sole proprietor health care provider with primary practice located at 380 Walker Drive , Rexburg ID 83440. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Dickson, Dane J can be contacted via phone (208) 356-9559.Contact Information
Primary practice address
380 Walker Drive
Rexburg ID 83440
Phone: (208) 356-9559
Fax: (208) 356-6601
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | M8118 | Idaho |
Profile Details
| NPI number | 1669497194 |
|---|---|
| LBN Legal business name | Dickson, Dane J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 13th, 2006 |
| Last updated | Jan 24th, 2008 - about 17 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 | 1669497194 | NPPES |
| Idaho | Other | 000010032448 | BLUE SHIELD |
| Idaho | Other | 8J950 | BLUE SHIELD |
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