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NPI Code Detail

MEDICARE: COURTNEY BROOKE DIXON

MEDICARE: COURTNEY BROOKE DIXON
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1790513927
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY BROOKE DIXON
Provider Business Mailing Address
First Line : PO BOX 1832
Second Line :
City : PITTSBURG
State : KS
Zip : 66762-1832
Country : US
Telephone Number : 888-777-9170
Fax Number :
Provider Business Practice Location Address
First Line : 2322 S MAIN ST
Second Line :
City : FORT SCOTT
State : KS
Zip : 66701-3026
Country : US
Telephone Number : 888-777-9170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2024
Last Update Date : 05/14/2026

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Directions to “ COURTNEY BROOKE DIXON ” Practice Location

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