Healthcare Provider Details

I. General information

NPI: 1770081374
Provider Name (Legal Business Name): BRION LINDSAY DIXON PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2018
Last Update Date: 01/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1363 7TH AVE E
HENDERSONVILLE NC
28792-2804
US

IV. Provider business mailing address

1363 7TH AVE E
HENDERSONVILLE NC
28792-2804
US

V. Phone/Fax

Practice location:
  • Phone: 828-698-5757
  • Fax: 828-698-5799
Mailing address:
  • Phone: 828-698-5757
  • Fax: 828-698-5799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-07822
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: