Provider Demographics
NPI:1528488558
Name:DICKEY, MAXWELL (MD)
Entity type:Individual
Prefix:DR
First Name:MAXWELL
Middle Name:
Last Name:DICKEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RAF CENTRE OF AVIATION MEDICINE
Mailing Address - Street 2:RAF HENLOW
Mailing Address - City:HENLOW
Mailing Address - State:BEDFORDSHIRE
Mailing Address - Zip Code:SG16 6DN
Mailing Address - Country:GB
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:RAF LAKENHEATH
Practice Address - Street 2:FLIGHT MEDICINE CLINIC
Practice Address - City:RAF LAKENHEATH
Practice Address - State:APO
Practice Address - Zip Code:09461
Practice Address - Country:GB
Practice Address - Phone:314-226-8010
Practice Address - Fax:314-226-8022
Is Sole Proprietor?:No
Enumeration Date:2014-04-17
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE28892208D00000X, 2083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice