Healthcare Provider Details

I. General information

NPI: 1518924356
Provider Name (Legal Business Name): JAMESINA M DICKSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2830 SW URISH RD
TOPEKA KS
66614-5614
US

IV. Provider business mailing address

2830 SW URISH RD
TOPEKA KS
66614-5614
US

V. Phone/Fax

Practice location:
  • Phone: 785-273-4010
  • Fax: 785-233-1404
Mailing address:
  • Phone: 785-233-5101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number04-28280
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: