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General NPI Number Information
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NPI Number | 1124495429
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Entity Type | Individual
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Provider Name | NIXON PIERRE R.T.(R)(CT)MR)
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Gender | Male
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Dates
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Enumeration Date | 08/21/2015
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Last Update Date | 08/21/2015
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Provider Practice Location Address
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Address Line | 5393 HIDDEN STREAM DR
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City | LEWISVILLE
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State | NC
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Zip | 27023-9807
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Country | US
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Telephone | 336-837-8609
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Fax |
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Provider Business Mailing Address
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Address Line | 5393 HIDDEN STREAM DR
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City | LEWISVILLE
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State | NC
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Zip | 27023-9807
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Country | US
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Telephone | 336-837-8609
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number | 509885
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License Number State | NC
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