Patricia a. Dickerson MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PATRICIA A. DICKERSON MD

Practice address

1299 E Alex Bell Rd
Centerville, OH 45459-2658

Phone

(937) 436-1117

Fax

(937) 436-9576

NPI assigned

Aug 18, 2006

Last updated

Nov 5, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Patricia A Dickerson, MDNPI 1336132950

Title

Owner

Phone

(937) 436-1117

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patricia A Dickerson, MD

  • Dermatology Physician
  • Centerville, OH
  • NPI 1336132950
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1215041041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1299 E ALEX BELL RD",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454592658",
            "telephone_number": "937-436-1117",
            "fax_number": "937-436-9576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 E ALEX BELL RD",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454592658",
            "telephone_number": "937-436-1117",
            "fax_number": "937-436-9576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIA A. DICKERSON MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2012-11-05",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-436-1117",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2831341",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Disha Patel, PHARMD
• Kamini P Patel, MD
• Ketana Patel
• Meenakshi C Patel, MD
• Shree Patel I, D.O.
• Patricia J. Hayes, Psy.D Associates
• Patrick Mezu MD LLC
• Brandye Patterson
• Paul D Entner (Agape Counseling Center)
• Paul J. Pawlosky OB-GYN, Inc.

• Dermatology Physician in Centerville, OH
• Providers in Centerville, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.