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General NPI Number Information
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NPI Number | 1508967126
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Entity Type | Individual
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Provider Name | MICHAEL JEROME DIXON MD
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 03/27/2018
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Provider Practice Location Address
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Address Line | 2550 E BROADWAY ST
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City | HELENA
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State | MT
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Zip | 59601-4905
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Country | US
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Telephone | 406-457-4180
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 6369
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City | HELENA
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State | MT
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Zip | 59604
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Country | US
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Telephone | 406-447-2823
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Fax | 406-447-2825
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 8300
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License Number State | MT
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