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1346218120 NPI number — TIMOTHY JAMES DICKASON M.D.

NPI Number: 1346218120
Health Care Provider/Practitioner: TIMOTHY JAMES DICKASON M.D.

Information about “1346218120” NPI (TIMOTHY JAMES DICKASON M.D.) exists in 1346218120 in HTML format HTML  |  1346218120 in plain Text format TXT  |  1346218120 in PDF (Portable Document Format) PDF  |  1346218120 in an XML format XML  formats.

NPI Number : 1346218120 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1346218120",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DICKASON",
    "FirstName": "TIMOTHY",
    "MiddleName": "JAMES",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1125 BARTOW RD STE 101A",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LAKELAND",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33801-5845",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "281-221-1823",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1125 BARTOW RD",
    "SecondLinePracticeLocationAddress": "STE 101",
    "PracticeLocationAddressCityName": "LAKELAND",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33801-5852",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "863-683-7171",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/09/2006",
    "LastUpdateDate": "11/11/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207ZP0102X",
          "TaxonomyName": "Anatomic Pathology & Clinical Pathology Physician",
          "LicenseNumber": "101101",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "207ZP0102X",
          "TaxonomyName": "Anatomic Pathology & Clinical Pathology Physician",
          "LicenseNumber": "M7144",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207ZH0000X",
          "TaxonomyName": "Hematology (Pathology) Physician",
          "LicenseNumber": "101101",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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