Healthcare Provider Details

I. General information

NPI: 1780770784
Provider Name (Legal Business Name): MEREDITH ANN HOLBROOK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEREDITH ANN DIXON M.D.

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 12/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2251 NORTH SHORE DR
RHINELANDER WI
54501-8360
US

IV. Provider business mailing address

2251 NORTH SHORE DR
RHINELANDER WI
54501-8360
US

V. Phone/Fax

Practice location:
  • Phone: 715-361-2000
  • Fax:
Mailing address:
  • Phone: 715-361-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number51653
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: