Provider Demographics
NPI:1376600916
Name:DICKINSON, HUGH ASHLEY (DC)
Entity Type:Individual
Prefix:
First Name:HUGH
Middle Name:ASHLEY
Last Name:DICKINSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 W COURT ST
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-4247
Mailing Address - Country:US
Mailing Address - Phone:870-239-5005
Mailing Address - Fax:870-239-5007
Practice Address - Street 1:620 W COURT ST
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-4247
Practice Address - Country:US
Practice Address - Phone:870-239-5005
Practice Address - Fax:870-239-5007
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1417111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARU71795OtherUPIN
AR5T329OtherBLUE CROSS BLUE SHIELD
ARU71795OtherUPIN