1528488558 NPI number — DR. MAXWELL DICKEY M.D.

Table of content: DR. MAXWELL DICKEY M.D. (NPI 1528488558)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528488558 NPI number — DR. MAXWELL DICKEY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DICKEY
Provider First Name:
MAXWELL
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1528488558
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
RAF CENTRE OF AVIATION MEDICINE
Provider Second Line Business Mailing Address:
RAF HENLOW
Provider Business Mailing Address City Name:
HENLOW
Provider Business Mailing Address State Name:
BEDFORDSHIRE
Provider Business Mailing Address Postal Code:
SG16 6DN
Provider Business Mailing Address Country Code:
GB
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
RAF LAKENHEATH
Provider Second Line Business Practice Location Address:
FLIGHT MEDICINE CLINIC
Provider Business Practice Location Address City Name:
RAF LAKENHEATH
Provider Business Practice Location Address State Name:
APO
Provider Business Practice Location Address Postal Code:
09461
Provider Business Practice Location Address Country Code:
GB
Provider Business Practice Location Address Telephone Number:
314-226-8010
Provider Business Practice Location Address Fax Number:
314-226-8022
Provider Enumeration Date:
04/17/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  28892 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2083A0100X , with the licence number: 28892 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com