MEDICARE: DIXIE A. FULLERTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609923242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIXIE A. FULLERTON

Provider Business Mailing Address
First Line	:	1621 FREMONT ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-5413
Country	:	US
Telephone Number	:	702-382-8287
Fax Number	:	702-388-0727

Provider Business Practice Location Address
First Line	:	1621 FREMONT ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-5413
Country	:	US
Telephone Number	:	702-382-8287
Fax Number	:	702-388-0727

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. DIXIE A FULLERTON
Credential	:
Telephone Number	:	702-382-8287

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	07/23/2012

Similar Medicare Providers

1558915066 — GABRIELA ARELLANO-MARTINEZ
Practice Location Address:

8600 W CHARLESTON BLVD APT 1147
LAS VEGAS, NV
89117-5413

Practice Phone: 702-619-4224
Practice Fax:

1598603466 — SHANNON ZACARIAS
Practice Location Address:

400 S 4TH ST STE 500
LAS VEGAS, NV
89101-6207

Practice Phone: 702-765-0983
Practice Fax:

1487503009 — SINGLE MOTHER'S OF CULTURE NFP
Practice Location Address:

1735 FREMONT ST
LAS VEGAS, NV
89101-5420

Practice Phone: 773-413-0153
Practice Fax:

1316885163 — DANIELLE JONES
Practice Location Address:

1521 LAS VEGAS BLVD N UNIT 257
LAS VEGAS, NV
89101-1133

Practice Phone: 480-248-5278
Practice Fax:

1467309567 — MINDWELL SOLUTIONS PLLC
Practice Location Address:

732 S 6TH ST STE R
LAS VEGAS, NV
89101-6948

Practice Phone: 702-861-3865
Practice Fax:

1578401030 — JESSE BISHOP
Practice Location Address:

400 S 4TH ST STE 500
LAS VEGAS, NV
89101-6207

Practice Phone: 702-765-0983
Practice Fax:

Directions to “DIXIE A. FULLERTON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.