NPI 1902256548 · live from the CMS NPI Registry
Daniel Jackson Dickman, D.O.
Radiology, Diagnostic Radiology in Boise, ID. National Provider Identifier 1902256548, active.
NPI record
| NPI | 1902256548 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 190 E Bannock St, Boise, ID 83712 |
| Practice phone | 208-381-2809 |
| Mailing address | 2894 W Neff St, Boise, ID 83703 |
| Enumerated | June 14, 2016 |
| Last updated | July 8, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Radiology, Diagnostic Radiology | 2085R0202X | 009081 (AZ) |
| Surgery | 208600000X | R2701 (AZ) |
| Student in an Organized Health Care Education/Training Program | 390200000X | — (NM) |
| Radiology, Diagnostic Radiology primary | 2085R0202X | O-1709 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.