Healthcare Provider Details

I. General information

NPI: 1952752586
Provider Name (Legal Business Name): ALEXANDER DICKSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2016
Last Update Date: 06/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 ANTRIM RD CHFHC
HILLSBORO NH
03244-5250
US

IV. Provider business mailing address

15 ANTRIM RD CHFHC
HILLSBORO NH
03244-5250
US

V. Phone/Fax

Practice location:
  • Phone: 603-464-3434
  • Fax: 603-464-3440
Mailing address:
  • Phone: 603-464-3434
  • Fax: 603-464-3440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRT-2976
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: