Dickson Medical Associates, PC
Organization Active NPI Surgery Physician · Dickson, TN
NPI 1689777922 · NPPES record last updated Sep 20, 2012
Key facts
- NPI
- 1689777922
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- DICKSON MEDICAL ASSOCIATES, PC
- Practice address
- 704 E College St
Dickson, TN 37055-2032 - Phone
- (615) 441-4504
- Fax
- (615) 446-1357
- NPI assigned
- Sep 5, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- DICKSON MEDICAL ASSOCIATES, PC
Authorized official
- Name
- Miss Cindy A Lighthill
- Title
- Executive Director
- Phone
- (615) 441-4477
Other NPIs on the same Medicare enrollment 11
Practitioners 6
-
Dolores J Lucas, MD
-
Gustavo Huerta, MD
-
Matthew L Sarb, D.O.
-
Lacey Kathleen Thompson, PA-C
-
John David Tullos, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031204000828 | TN | Part B Supplier - Clinic/Group Practice | 3971408774 |
Receives reassigned benefits from 58 practitioners 13 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: White Bluff, TN; Waverly, TN; Hohenwald, TN; Fairview, TN; Dickson, TN; Clarksville, TN |
National Provider Directory
- Part of
- Jackson Clinic Prof Ass
Locations
111 Highway 70 E
Dickson, TN 37055
Phone (615) 441-2357
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | Yes | ||
| Vascular Surgery Physician |
2086S0129X |
Addresses
Primary practice location
704 E College St
Dickson, TN 37055-2032
Mailing address
127 Crestview Park Dr
Dickson, TN 37055-2855
Phone (615) 446-5121
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3158185 | Other | TN | BCBS TN GROUP PIN |
| 3721355 | Medicaid | TN |
Other names
- DMA General Surgery & Endoscopy Center
Other providers in Dickson, TN
- Dickson Medical Associates PC
- Dickson Medical Associates PC
- Dickson Medical Associates PC
- Dickson Medical Associates, PC
- Dickson Medical Associates, PC
- Dickson Medical Associates, PC
- Dickson Medical Associates, PC
- Dickson Medical Associates, PC
- Dickson Medical Associates, PC
- Dickson Medical Associates, PC
All providers in Dickson, TN · Surgery Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.