Healthcare Provider Details

I. General information

NPI: 1548325087
Provider Name (Legal Business Name): JOE WHEELER DIXON PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 CONFERENCE DR
GREENVILLE NC
27858-5971
US

IV. Provider business mailing address

3800 OGLETHORPE DR
WINTERVILLE NC
28590
US

V. Phone/Fax

Practice location:
  • Phone: 252-756-4899
  • Fax: 252-756-5141
Mailing address:
  • Phone: 252-355-7672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2951
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number2951
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number2951
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number2951
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: