Healthcare Provider Details

I. General information

NPI: 1427262591
Provider Name (Legal Business Name): WILLIAM N DIXON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 09/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 ASTON AVE
MCCOMB MS
39648-2825
US

IV. Provider business mailing address

1311 ASTON AVE
MCCOMB MS
39648-2825
US

V. Phone/Fax

Practice location:
  • Phone: 601-684-2481
  • Fax: 601-684-2488
Mailing address:
  • Phone: 601-684-2481
  • Fax: 601-684-2488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number14639
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: