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General NPI Number Information
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NPI Number | 1679691604
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Entity Type | Individual
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Provider Name | JAMES R DICKSON MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3020 WESTCHESTER AVE SUITE 305
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City | PURCHASE
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State | NY
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Zip | 10577
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Country | US
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Telephone | 914-253-8011
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Fax | 914-253-8099
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Provider Business Mailing Address
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Address Line | 3020 WESTCHESTER AVE SUITE 305
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City | PURCHASE
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State | NY
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Zip | 10577
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Country | US
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Telephone | 914-253-8011
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Fax | 914-253-8099
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 112400
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License Number State | NY
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