MEDICARE: DREW DICKSON

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
1	207W00000X	Ophthalmology Physician	MD-52809	IA
2	207W00000X	Ophthalmology Physician	33546	NE

General Provider Information

NPI Number	:	1255865788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DREW DICKSON

Provider Business Mailing Address
First Line	:	16318 SPRING CIR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68130-2036
Country	:	US
Telephone Number	:	402-677-1114
Fax Number	:

Provider Business Practice Location Address
First Line	:	17838 BURKE ST STE 100
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68118-2256
Country	:	US
Telephone Number	:	402-558-2211
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2017
Last Update Date	:	02/04/2026

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Directions to “ DREW DICKSON ” Practice Location

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