MEDICARE: RAPHILLA D DIXIE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	87001756A	IN

General Provider Information

NPI Number	:	1003465873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAPHILLA D DIXIE

Provider Business Mailing Address
First Line	:	3005 E STATE BLVD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-4736
Country	:	US
Telephone Number	:	260-267-9498
Fax Number	:

Provider Business Practice Location Address
First Line	:	3005 E STATE BLVD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-4736
Country	:	US
Telephone Number	:	260-267-9498
Fax Number	:	260-739-3618

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2019
Last Update Date	:	04/03/2024

Similar Medicare Providers

1992801492 — DR. JOHN ANTHONY BUONOCORE D.O.
Practice Location Address:

3005 E STATE BLVD
FORT WAYNE, IN
46805-4736

Practice Phone: 260-267-9498
Practice Fax:

1922470970 — JENNIFER CAROL LITTKE AGPCNP-BC
Practice Location Address:

3005 E STATE BLVD
FORT WAYNE, IN
46805-4736

Practice Phone: 260-267-9498
Practice Fax: 260-739-3618

1124540455 — SUSAN EILEEN BAILEY CNP
Practice Location Address:

3005 E STATE BLVD
FORT WAYNE, IN
46805-4736

Practice Phone: 260-267-9498
Practice Fax:

1487393690 — ZEENAT HABIBULLAH MD
Practice Location Address:

3005 E STATE BLVD
FORT WAYNE, IN
46805-4736

Practice Phone: 260-267-9498
Practice Fax:

1477260230 — WAYNE HOME CARE AGENCY INC.
Practice Location Address:

3007 E STATE BLVD
FORT WAYNE, IN
46805-4736

Practice Phone: 260-445-7752
Practice Fax:

1336156777 — DR. CHARLES EDWARD HARTSFIELD JR. D.D.S.,M.S.
Practice Location Address:

613 LEXINGTON AVE
FORT SMITH, AR
72901-4736

Practice Phone: 479-782-7230
Practice Fax: 429-782-7230

Directions to “ RAPHILLA D DIXIE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.