Dr. Ty Dickerson
M.D. | Pediatrics | Male
Dr. Ty Dickerson, M.D. is a Salt Lake City, Utah based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Dr. Ty Dickerson is
100 N Medical Dr, Pcmc, Inpatient Medicine Division, Salt Lake City, Utah - 84113-1103. He can be contacted on phone at
801-588-3813.
Dr. Ty Dickerson is a sole proprietor of his business.
NPI number (Unique professional ID) for Dr. Ty Dickerson is
1639102684 which was assigned by NPPES on 09 Jul, 2006 and it was last updated on 20 Oct, 2021.
Dr. Ty Dickerson license number is
6279497-1205 for Pediatrics (208000000X) in Utah.
Dr. Ty Dickerson is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Dr. Ty Dickerson basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
|---|
| Provider Name : | Dr. Ty Dickerson |
|---|
| Credential : | M.D. |
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| Gender : | Male |
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Business Address:
Dr. Ty Dickerson address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 100 N Medical Dr, Pcmc, Inpatient Medicine Division
Salt Lake City, UT, 84113-1103
United States |
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| Phone Number : | 801-588-3813 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1639102684 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 09 Jul, 2006 |
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| Last Updated On : | 20 Oct, 2021 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Ty Dickerson are as mentioned. Primary taxonomy code for Dr. Ty Dickerson, M.D. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 6279497-1205 | UT |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Ty Dickerson such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 02181735 | MEDICAID | NY | |
Endpoints:
Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).
| Endpoint Type | Endpoint | Affiliation | Use | Content | Address |
|---|
DIRECT
(Direct Messaging Address) | tdickerson90116@direct.med.utah.edu
| | DIRECT
Direct
| OTHER
Other
CDA/CCD/TXT | 50 N MEDICAL DR,
SALT LAKE CITY, UT, 84132-0001
United States |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 1842 S 1100 E
Salt Lake City, UT, 84105-3414
United States |
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| Phone Number : | 585-224-5122 |
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| Fax Number : | 801-662-3664 |
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Business Location:
Patients can refer following map for directions to
Dr. Ty Dickerson practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.