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General NPI Number Information
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NPI Number | 1710942867
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Entity Type | Organization
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Legal Business Name | DIXON PRIMARY CARE
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 03/21/2008
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Provider Practice Location Address
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Address Line | 720 MARKET ST
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City | WILMINGTON
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State | NC
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Zip | 28401-4647
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Country | US
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Telephone | 910-762-9995
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Fax | 910-762-2134
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Provider Business Mailing Address
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Address Line | 720 MARKET ST
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City | WILMINGTON
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State | NC
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Zip | 28401-4647
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Country | US
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Telephone | 910-762-9995
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Fax | 910-762-2134
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Authorized Official
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Title or Position | OWNER
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Name | MR. DOUGLAS MICHAEL DIXON
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Credential | M.D.
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Telephone | 910-762-9995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | NC
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