Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jonathan David Dickson, PA-C

Individual provider Physician Assistant · NPI 1487110474

Jonathan David Dickson, PA-C is a Physician Assistant in Fayetteville, Arkansas. Qualified in 2019, 7 years ago. Practices with Advanced Dermatology and Skin Cancer Center, LLC, a 9-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Arkansas and Texas.

Years since qualifying
7
Licensed in
AR, TX
In the registry since
2019
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1444 E Stearns St Ste 11
Fayetteville, AR 72703-4969
Phone: (479) 718-7546
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 492 Foster Chapel Rd, Searcy, AR 72143-9605 — (903) 530-7986
  • 627 Turtle Creek Dr, Tyler, TX 75701-1832 — (903) 593-2539

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-1154 (AR)
Physician Assistant Taxonomy 363A00000X · Licence PA13777 (TX)

Record details

NPI number1487110474
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedFebruary 14, 2019
Last updated in NPPESMay 1, 2023
Certification dateMay 1, 2023
Mailing address1444 E Stearns St Ste 11, Fayetteville, AR 72703-4969

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Advanced Dermatology And Skin Cancer Center, Llc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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