Healthcare Provider Details

I. General information

NPI: 1497788301
Provider Name (Legal Business Name): JAMES R DICKEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 11/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E SHERMAN ST
WEST POINT NE
68788-2229
US

IV. Provider business mailing address

115 E SHERMAN ST
WEST POINT NE
68788-2229
US

V. Phone/Fax

Practice location:
  • Phone: 402-372-9900
  • Fax: 402-372-9909
Mailing address:
  • Phone: 402-372-9900
  • Fax: 402-372-9909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2006017836
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: