MEDICARE: DR. RICHARD MICHAEL DIX M.D., J.D.

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	207X00000X	Orthopaedic Surgery Physician	3629	NV

General Provider Information

NPI Number	:	1215141072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD MICHAEL DIX M.D., J.D.

Provider Business Mailing Address
First Line	:	P.O. BOX 50129
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89016-0129
Country	:	US
Telephone Number	:	702-499-6260
Fax Number	:	702-451-0517

Provider Business Practice Location Address
First Line	:	2080 EAST FLAMINGO RD
Second Line	:	SUITE 301
City	:	LAS VEGAS
State	:	NV
Zip	:	89119
Country	:	US
Telephone Number	:	702-499-6260
Fax Number	:	702-451-0517

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

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	07/08/2007

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