MEDICARE: DR. JASON KENNETH DICKERSON O.D.

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	152W00000X	Optometrist	S-982-TA-567	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	U86291	OTHER	AL	HEALTHSPRING
2	U86291	OTHER	AL	UNITED HEALTHCARE
3	U86291	OTHER	AL	VIVA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	51505633	OTHER	AL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1487646832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON KENNETH DICKERSON O.D.

Provider Business Mailing Address
First Line	:	2617 HIGHWAY 31 S
Second Line	:
City	:	PELHAM
State	:	AL
Zip	:	35124-1322
Country	:	US
Telephone Number	:	205-664-1575
Fax Number	:	205-664-1578

Provider Business Practice Location Address
First Line	:	2617 HIGHWAY 31 S
Second Line	:
City	:	PELHAM
State	:	AL
Zip	:	35124-1322
Country	:	US
Telephone Number	:	205-664-1575
Fax Number	:	205-664-1578

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

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	06/10/2008

Similar Medicare Providers

1679565055 — DR. CHRISTI CRABTREE HILL O.D.
Practice Location Address:

2617 HIGHWAY 31 S
PELHAM, AL
35124-1322

Practice Phone: 205-664-1575
Practice Fax: 205-664-1578

1134111511 — DR. DOUGLAS CURTIS CLARK O.D.
Practice Location Address:

2617 HIGHWAY 31 S
PELHAM, AL
35124-1322

Practice Phone: 205-664-1575
Practice Fax: 205-664-1578

1265444293 — RENA C LEWIS
Practice Location Address:

2617 HIGHWAY 31 S
PELHAM, AL
35124-1322

Practice Phone: 205-664-1575
Practice Fax:

1962561746 — DR. MICHAEL SETH WILLIAMS O.D.
Practice Location Address:

2617 PELHAM PKWY
PELHAM, AL
35124-1322

Practice Phone: 205-664-1575
Practice Fax: 205-664-1578

1386791770 — DR. ANN B. O'REAR D.M.D.
Practice Location Address:

2619 PELHAM PKWY
PELHAM, AL
35124-1322

Practice Phone: 205-663-7786
Practice Fax:

1699808295 — DOUGLAS C CLARK, OD, INC
Practice Location Address:

2617 PELHAM PKWY
PELHAM, AL
35124-1322

Practice Phone: 205-664-1575
Practice Fax: 205-664-1578

Directions to “ DR. JASON KENNETH DICKERSON O.D.” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.