Healthcare Provider Details
I. General information
NPI: 1720073083
Provider Name (Legal Business Name): DEBRA J BIXLER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/13/2005
Last Update Date: 10/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1212 PLEASANT ST SUITE 300
DES MOINES IA
50309-1414
US
IV. Provider business mailing address
1212 PLEASANT ST SUITE 300
DES MOINES IA
50309-1414
US
V. Phone/Fax
- Phone: 515-241-8923
- Fax: 515-241-8728
- Phone: 515-241-8923
- Fax: 515-241-8728
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 02095 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: