Slocum Dickson Medical Group Pllc
LBN: Slocum Dickson Medical Group Pllc
Slocum Dickson Medical Group Pllc is an health care organization with primary practice located at 1729 Burrstone Rd , New Hartford NY 13413-1001. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Clinic/Center, Laboratories / Clinical Medical Laboratory. Ambulatory Health Care Facilities / Clinic/Center is the primary health care specialty.
Slocum Dickson Medical Group Pllc can be contacted via phone (315) 798-1700, or through Eadline, Stephen D. via phone (315) 798-1700.
Contact Information
Primary practice address
1729 Burrstone Rd
New Hartford NY 13413-1001
Phone: (315) 798-1700
Fax: (315) 798-1707
Website:
Authorized official contact:
Name: Eadline, Stephen D. Doctor of Medicine (MD)
Phone: (315) 798-1700
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X | 47440 | New York |
| Laboratories / Clinical Medical Laboratory | 291U00000X |
Profile Details
| NPI number | 1285625996 |
|---|---|
| LBN Legal business name | Slocum Dickson Medical Group Pllc |
| DBA Doing business as | |
| Authorized official | Eadline, Stephen D. Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 2nd, 2005 |
| Last updated | Jun 11th, 2021 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285625996 | NPPES |
| New York | MEDICAID | 02995013 |
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