Dickson, Matthew Jordan

Dickson, Matthew Jordan is an individual health care provider with primary practice located at 14 Hudson Avenue Adirondack Ent, Glens Falls NY 12801-4363. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Facial Plastic Surgery, Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery. Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery is his primary health care specialty. Dickson, Matthew Jordan can be contacted via phone (518) 926-1380.

Contact Information

Primary practice address
14 Hudson Avenue Adirondack Ent Glens Falls NY 12801-4363
Phone: (518) 926-1380
Fax: (518) 926-1385
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Facial Plastic Surgery 207YS0123X 57061 Georgia
Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery 207YX0905X 244280 New York

Profile Details

NPI number 1528021706
LBN Legal business name Dickson, Matthew Jordan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Aug 10th, 2023 - about 2 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 1528021706 NPPES
New York MEDICAID 02897047

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