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General NPI Number Information
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NPI Number | 1750621579
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Entity Type | Individual
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Provider Name | TIMOTHY CLAYTON DICKEY FNP-C
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Gender | Male
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Dates
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Enumeration Date | 02/15/2013
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Last Update Date | 03/18/2013
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Provider Practice Location Address
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Address Line | 927 N JAMES CAMPBELL BLVD SUITE 105
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City | COLUMBIA
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State | TN
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Zip | 38401-2753
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Country | US
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Telephone | 931-388-5114
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Fax | 931-388-5631
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Provider Business Mailing Address
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Address Line | 501 GREAT CIRCLE RD SUITE 200
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City | NASHVILLE
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State | TN
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Zip | 37228-1317
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Country | US
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Telephone | 931-388-5114
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Fax | 931-388-5631
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 17305
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License Number State | TN
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