Malcolm J. Dickerson, M.D., P.C.

Organization Active NPI Family Medicine Physician · Eldon, MO

NPI 1033440342 · NPPES record last updated Jan 26, 2010

Key facts

NPI
1033440342
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
R5N38 (MO)
Legal business name
MALCOLM J. DICKERSON, M.D., P.C.
Practice address
411 W 4TH St
Eldon, MO 65026-1919
Phone
(573) 392-9200
Fax
(573) 392-4626
NPI assigned
Jan 26, 2010
Organization subpart
No

Authorized official

Name
Ms. Vicki Jo Routon
Title
Practice Manager
Phone
(573) 392-9200

National Provider Directory

Locations

411 W 4th St
Eldon, MO 65026
Phone (573) 392-9200

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X R5N38 MO Yes

Addresses

Primary practice location

411 W 4TH St
Eldon, MO 65026-1919

Mailing address

411 W 4TH St
Eldon, MO 65026-1919
Phone (573) 392-9200

Other providers in Eldon, MO

All providers in Eldon, MO · Family Medicine Physician in Missouri

Sources for this page

Verify at the official NPI Registry.