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NPI Code Detail

MEDICARE: JIMMY DON DICKERSON

MEDICARE: JIMMY DON DICKERSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1372600000XAdult Companion

General Provider Information

NPI Number : 1255271243
Entity Type Code : Individual
Provider Name (Legal Business Name) : JIMMY DON DICKERSON
Provider Business Mailing Address
First Line : 66133 GOLD CT
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72209
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 66133 GOLD CT
Second Line : 66133 GOLD CT
City : LITTLE ROCK
State : AR
Zip : 72209
Country : US
Telephone Number : 501-235-0909
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2026
Last Update Date : 03/30/2026

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Directions to “ JIMMY DON DICKERSON ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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