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NPI Code Detail

MEDICARE: DR. DOUGLAS JAMES DICKEY M.D.

MEDICARE: DR. DOUGLAS JAMES DICKEY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician2011012590MO
2207Q00000XFamily Medicine Physician35-06-5652OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932487790
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS JAMES DICKEY M.D.
Provider Business Mailing Address
First Line : 13008 FALMOUTH ST
Second Line :
City : LEAWOOD
State : KS
Zip : 66209-1788
Country : US
Telephone Number : 913-766-1110
Fax Number :
Provider Business Practice Location Address
First Line : 2901 ROCKCREEK PKWY
Second Line :
City : KANSAS CITY
State : MO
Zip : 64117-2536
Country : US
Telephone Number : 816-201-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2011
Last Update Date : 07/28/2011

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