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General NPI Number Information
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NPI Number | 1417970708
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Entity Type | Organization
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Legal Business Name | PETER S. DIXON, M.D, P.C.
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 05/20/2015
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Provider Practice Location Address
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Address Line | 192 WESTBROOK RD
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City | ESSEX
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State | CT
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Zip | 06426-1511
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Country | US
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Telephone | 860-767-1200
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Fax | 860-767-3031
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Provider Business Mailing Address
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Address Line | 192 WESTBROOK RD
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City | ESSEX
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State | CT
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Zip | 06426-1511
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Country | US
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Telephone | 860-767-1200
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Fax | 860-767-3031
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Authorized Official
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Title or Position | OWNER
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Name | DR. PETER S DIXON
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Credential | M.D.
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Telephone | 860-767-1200
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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 | 33140
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License Number State | CT
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