| Dr Otto Frederick Dickman Iv, MD | |
| 
					90 West Main, Emery Medical Center, Castle Dale, UT 84513-0607  | |
| (435) 381-2305 | |
| (435) 381-4535 | 
| Full Name | Dr Otto Frederick Dickman Iv | 
|---|---|
| Gender | Male | 
| Speciality | Family Medicine | 
| Location | 90 West Main, Castle Dale, Utah | 
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1619065943 | NPI | - | NPPES | 
| 621762357076 | Medicaid | UT | |
| 621762357080 | Medicaid | UT | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | 495-6304-1205 (Utah) | Primary | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Otto Frederick Dickman Iv, MD Po Box 607, Emery Medical Center, Castle Dale, UT 84513-0607 Ph: (435) 381-2305  | Dr Otto Frederick Dickman Iv, MD 90 West Main, Emery Medical Center, Castle Dale, UT 84513-0607 Ph: (435) 381-2305  |