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General NPI Number Information
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NPI Number | 1699270728
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Entity Type | Individual
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Provider Name | KRISTOPHER LIN DIXON MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2018
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 9 RICHLAND MEDICAL PARK DR STE 530
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City | COLUMBIA
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State | SC
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Zip | 29203-6870
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Country | US
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Telephone | 803-434-4603
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Fax | 803-434-7983
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Provider Business Mailing Address
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Address Line | 300 E MCBEE AVE FL 4
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City | GREENVILLE
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State | SC
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Zip | 29601-2842
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Country | US
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Telephone | 864-695-6697
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD473629
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 91584
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License Number State | SC
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