Provider Demographics
NPI:1134193188
Name:DICKS, ROBERT E (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:DICKS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:701 E COUNTY LINE RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1072
Mailing Address - Country:US
Mailing Address - Phone:317-882-0535
Mailing Address - Fax:317-882-0173
Practice Address - Street 1:701 E COUNTY LINE RD
Practice Address - Street 2:SUITE 250
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1072
Practice Address - Country:US
Practice Address - Phone:317-882-0535
Practice Address - Fax:317-882-0173
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2016-01-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01022713A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INC24263Medicare UPIN
IN132440WMedicare ID - Type Unspecified
IN080192144OtherRAILROAD MEDICARE