Healthcare Provider Details

I. General information

NPI: 1467656462
Provider Name (Legal Business Name): EMILY E DIXON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY E WOLCOTT

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 09/07/2021
Certification Date: 09/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8311 MONTGOMERY RD
CINCINNATI OH
45236-2227
US

IV. Provider business mailing address

6480 HARRISON AVE STE 201
CINCINNATI OH
45247-7961
US

V. Phone/Fax

Practice location:
  • Phone: 513-354-3700
  • Fax: 513-246-2391
Mailing address:
  • Phone: 513-354-7650
  • Fax: 513-246-2391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number37.009730
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: