DIXON FAMILY PRACTICE AND INTERNAL MEDICINE LLC NPI 1235135682

NPI Information

DIXON FAMILY PRACTICE AND INTERNAL MEDICINE, LLC is a rural health clinic center in Dixon, MO. DIXON FAMILY PRACTICE AND INTERNAL MEDICINE, LLC NPI is 1235135682. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

206 WEST 2ND STREET
DIXON, MO
ZIP 65459-940
Phone: (573) 759-3030
Fax: (573) 759-3131

The provider's authorized official is Carlene S Mcmillian .
The authorized official title is Owner and has the following contact phone number (573) 759-3030.

The CLIA number assigned to this NPI record is 26D0930428 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/21/2005 and was last updated on 4/29/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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