Jacob Lane Dickinson, D.O. is a student in an organized health care education training program in Southampton, NY. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Jacob Lane Dickinson, D.O. NPI is 1407316821. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
240 MEETING HOUSE LN
SOUTHAMPTON, NY
ZIP 11968-009
Phone: (631) 726-0409
The enumeration date for this NPI number is 3/21/2019 and was last updated on 3/21/2019.