Dickson, Stephen L
Dickson, Stephen L is an individual health care provider with primary practice located at 2500 Niles Rd Ste 6 , Saint Joseph MI 49085-3268. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Dickson, Stephen L can be contacted via phone (269) 408-1660.Contact Information
Primary practice address
2500 Niles Rd Ste 6
Saint Joseph MI 49085-3268
Phone: (269) 408-1660
Fax: (269) 408-1665
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 43991 | Kentucky |
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 01058168A | Indiana |
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 4301114501 | Michigan |
Profile Details
| NPI number | 1720086242 |
|---|---|
| LBN Legal business name | Dickson, Stephen L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 8th, 2005 |
| Last updated | Jun 17th, 2020 - 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 | 1720086242 | NPPES |
| Kentucky | Other | 50031859 | PASSPORT- CTS |
| Kentucky | Other | 000057094V | PASSPORT- CTS |
| Kentucky | MEDICAID | 64076821 | PASSPORT- CTS |
| Kentucky | MEDICAID | 200455130A | PASSPORT- CTS |
| Kentucky | Other | 000000701004 | PASSPORT- CTS |
| Kentucky | MEDICAID | 200455130 | PASSPORT- CTS |
| Kentucky | Other | 4001605 | PASSPORT- CTS |
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