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General NPI Number Information
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NPI Number | 1174646723
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Entity Type | Individual
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Provider Name | KAREN DIXON CSA
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Gender | Female
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 02/01/2010
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Provider Practice Location Address
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Address Line | 325 FIELDSTONE PKWY
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City | JONESBORO
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State | GA
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Zip | 30236-7502
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Country | US
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Telephone | 678-499-5103
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Fax | 770-629-5554
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Provider Business Mailing Address
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Address Line | PO BOX 960843
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City | RIVERDALE
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State | GA
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Zip | 30296-0843
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Country | US
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Telephone | 678-499-5103
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Fax | 770-629-5554
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 2900
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License Number State | GA
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