1881702199 NPI number — DICKSON MEDICAL ASSOCIATES, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881702199 NPI number — DICKSON MEDICAL ASSOCIATES, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DICKSON MEDICAL ASSOCIATES, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881702199
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/26/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
02/29/2012
NPI Reactivation Date:
07/16/2015

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
127 CRESTVIEW PARK DR
Provider Second Line Business Mailing Address:
SUITE 209
Provider Business Mailing Address City Name:
DICKSON
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37055-2855
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-441-4478
Provider Business Mailing Address Fax Number:
615-446-1357

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
768 HIGHWAY 46 S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DICKSON
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37055-2556
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-441-4400
Provider Business Practice Location Address Fax Number:
615-441-4443
Provider Enumeration Date:
08/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STRONG
Authorized Official First Name:
CHRISTIE
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
615-441-4477

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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