| Doctor Name: | MR. ZACHARY WILLIAM DICKSON |
| NPI Number: | 1114217221 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ARNP-C |
| License Number: | ARNP9249989 |
| Business Practice Address: | 1410 Brickyard Rd Chipley, FL - 324285966 |
| Business Phone Number: | 8506383400 |
| Business Fax Number: | |
| Mailing Address: | 1410 Brickyard Rd, CHIPLEY |
| State: | FL |
| Postal Code: | 324285966 |
| Phone Number: | 8506383400 |
| Fax Number: | |
| NPI Enumeration Date: | 04/10/2011 |
| NPI Last Update Date: | 04/10/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | ARNP9249989 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |