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General NPI Number Information
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NPI Number | 1255492401
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Entity Type | Individual
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Provider Name | KEITH L DIXON PT
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Gender | Male
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 631 BEACON PKWY W SUITE 110
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City | BIRMINGHAM
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State | AL
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Zip | 35209-3124
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Country | US
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Telephone | 205-945-4859
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Fax |
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Provider Business Mailing Address
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Address Line | 633 FOUNDERS PARK DR W
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City | BIRMINGHAM
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State | AL
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Zip | 35226-4137
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Country | US
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Telephone |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | PTH4822
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License Number State | AL
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