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General NPI Number Information
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NPI Number | 1285793364
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Entity Type | Individual
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Provider Name | MICHAEL ALBERT NIXON M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 0N025 WINFIELD RD
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City | WINFIELD
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State | IL
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Zip | 60190-1237
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Country | US
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Telephone | 630-933-4240
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Fax | 630-933-2675
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Provider Business Mailing Address
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Address Line | 0S574 REBECCA LN
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City | WINFIELD
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State | IL
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Zip | 60190-1500
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Country | US
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Telephone | 630-665-1834
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Fax | 630-665-1835
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State | IL
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