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General NPI Number Information
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NPI Number | 1184610727
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Entity Type | Individual
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Provider Name | DAVID DIXON CRNA
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 2801 BAY PARK DR DEPARTMENT OF SURGERY
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City | OREGON
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State | OH
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Zip | 43616-4920
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Country | US
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Telephone | 419-690-7652
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Fax | 419-697-7726
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Provider Business Mailing Address
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Address Line | 1932 COUNTY ROAD 213
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City | FREMONT
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State | OH
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Zip | 43420-9185
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Country | US
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Telephone | 419-639-3545
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | COA04747NA
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License Number State | OH
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