Healthcare Provider Details

I. General information

NPI: 1164645875
Provider Name (Legal Business Name): DIXON H MILLER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 OLDE HOMESTEAD LN SUITE 201
LANCASTER PA
17601-6751
US

IV. Provider business mailing address

1817 OLDE HOMESTEAD LN SUITE 201
LANCASTER PA
17601-6751
US

V. Phone/Fax

Practice location:
  • Phone: 717-394-3466
  • Fax:
Mailing address:
  • Phone: 717-394-3466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPS004228L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: