Provider Demographics
NPI:1508861006
Name:DICKEY, JAMES A (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:DICKEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-7805
Mailing Address - Country:US
Mailing Address - Phone:308-430-1305
Mailing Address - Fax:
Practice Address - Street 1:430 ARLINGTON RD
Practice Address - Street 2:SUITE B
Practice Address - City:BROOKVILLE
Practice Address - State:OH
Practice Address - Zip Code:45309-1103
Practice Address - Country:US
Practice Address - Phone:937-770-1265
Practice Address - Fax:937-770-1268
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1234152WC0802X, 152W00000X
OH3342152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE07163OtherBLUE CROSS BLUE SHIELD
OHH222730Medicare PIN
T47005Medicare UPIN