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NPI Code Detail

MEDICARE: ESTRELITA A DIXON M.D.

MEDICARE: ESTRELITA A DIXON M.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
1207R00000XInternal Medicine Physician35-063774OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255396123
Entity Type Code : Individual
Provider Name (Legal Business Name) : ESTRELITA A DIXON M.D.
Provider Business Mailing Address
First Line : PO BOX 636256
Second Line : CENTRAL CREDENTIALING
City : CINCINNATI
State : OH
Zip : 45263-6256
Country : US
Telephone Number : 513-585-5504
Fax Number :
Provider Business Practice Location Address
First Line : 3130 HIGHLAND AVE
Second Line : ML 0782
City : CINCINNATI
State : OH
Zip : 45219-2399
Country : US
Telephone Number : 513-584-4503
Fax Number : 513-584-0462
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2006
Last Update Date : 02/28/2019

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Directions to “ ESTRELITA A DIXON M.D.” Practice Location

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