Dickson, Jonathan L

Dickson, Jonathan L is an individual health care provider with primary practice located at 801 Broadway N , Fargo ND 58102-3641. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Dickson, Jonathan L can be contacted via phone (701) 234-2000.

Contact Information

Primary practice address
801 Broadway N Fargo ND 58102-3641
Fax: (701) 234-3813
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 4339 North Dakota

Profile Details

NPI number 1063430619
LBN Legal business name Dickson, Jonathan L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Jan 18th, 2012 - about 12 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 1063430619 NPPES
North Dakota MEDICAID 13282
North Dakota MEDICAID 921898000

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