National Provider Identifier
Kenneth Robert Dickerson, O.D.
Kenneth Robert Dickerson, O.D. is listed in the NPPES registry with a primary specialty of Optometrist in Rochester, NY and a listed phone number of (585) 273-3937.
Profile Overview
- NPI
- 1588778393
- Provider Type
- Individual
- Primary Specialty
- Optometrist
- Enumeration Date
- August 18, 2006
- Last Updated
- July 22, 2016
Practice Location
- 601 Elmwood Ave
- Rochester, NY 14642-0001
Phone: (585) 273-3937
Mailing Address
- 601 Elmwood Ave
- Box 888
- Rochester, NY 14642-0001
Specialties
- Optometrist (152W00000X)
Full Record
- NPI
- 1588778393
- Entity Type
- Individual
- Last Name
- Dickerson
- First Name
- Kenneth
- Middle Name
- Robert
- Credential
- O.D.
- Mailing Street Address
- 601 Elmwood Ave
- Mailing Address Line 2
- Box 888
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14642-0001
- Mailing Country
- US
- Mailing Phone
- (585) 273-3937
- Mailing Fax
- (585) 506-4185
- Practice Street Address
- 601 Elmwood Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14642-0001
- Practice Country
- US
- Practice Phone
- (585) 273-3937
- Practice Fax
- (585) 506-4185
- Enumeration Date
- August 18, 2006
- Last Updated
- July 22, 2016
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Optometrist (152W00000X)