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General NPI Number Information
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NPI Number | 1538383542
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Entity Type | Organization
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Legal Business Name | DAVID T.NIXON MD PA
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 02/14/2011
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Provider Practice Location Address
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Address Line | 1716 W 42ND AVE
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City | PINE BLUFF
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State | AR
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Zip | 71603-7008
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Country | US
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Telephone | 870-534-2624
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Fax | 870-534-2630
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Provider Business Mailing Address
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Address Line | 1716 W 42ND AVE
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City | PINE BLUFF
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State | AR
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Zip | 71603-7008
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Country | US
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Telephone | 870-534-2624
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Fax | 870-534-2630
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID T. NIXON
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Credential | MD
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Telephone | 870-534-2624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | C5815
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License Number State | AR
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