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General NPI Number Information
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NPI Number | 1134784937
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Entity Type | Individual
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Provider Name | KOBY MICHAEL DIXON SR. MD
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Gender | Male
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Dates
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Enumeration Date | 05/07/2019
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 6330 QUADRANGLE DR STE 500
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City | CHAPEL HILL
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State | NC
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Zip | 27517-8281
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Country | US
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Telephone | 888-849-7379
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Fax |
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Provider Business Mailing Address
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Address Line | 9228 SAWGRASS DR
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City | MIAMISBURG
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State | OH
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Zip | 45342-6778
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Country | US
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Telephone | 937-572-9218
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 35.149721
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License Number State | OH
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