| Mario S Dickens, DPM | |
|
6116 Shallowford Rd, Ste 118, Chattanooga, TN 37421-7201 | |
| (423) 710-1224 | |
| (423) 710-1228 |
| Full Name | Mario S Dickens |
|---|---|
| Gender | Male |
| Speciality | Podiatry |
| Experience | 26 Years |
| Location | 6116 Shallowford Rd, Chattanooga, Tennessee |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902843154 | NPI | - | NPPES |
| 4342355 | Medicaid | MI | |
| P00744501 | Other | RAILROAD MEDICARE | |
| 1512827 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | 690 (Tennessee) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Special Care Podiatry Of Georgia Llc | 4880913490 | 13 |
| Special Care Podiatry Of Tennessee, Llc | 8820398696 | 10 |
| Provider Name | Special Care Podiatry Of Georgia Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1891195962 PECOS PAC ID: 4880913490 Enrollment ID: O20150504001131 |
| Mailing Address | Practice Location Address |
|---|---|
| Mario S Dickens, DPM 6116 Shallowford Rd, Ste 118, Chattanooga, TN 37421-7201 Ph: (423) 710-1224 | Mario S Dickens, DPM 6116 Shallowford Rd, Ste 118, Chattanooga, TN 37421-7201 Ph: (423) 710-1224 |
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