MEDICARE: CURTIS L. DIX, OD, PC

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	152W00000X	Optometrist	1381T	OR

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	:	1982889143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CURTIS L. DIX, OD, PC

Provider Business Mailing Address
First Line	:	211 SE 5TH ST
Second Line	:
City	:	MADRAS
State	:	OR
Zip	:	97741-1603
Country	:	US
Telephone Number	:	541-475-2020
Fax Number	:	541-475-6118

Provider Business Practice Location Address
First Line	:	211 SE 5TH ST
Second Line	:
City	:	MADRAS
State	:	OR
Zip	:	97741-1603
Country	:	US
Telephone Number	:	541-475-2020
Fax Number	:	541-475-6118

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. CURTIS LEE DIX
Credential	:	O.D.
Telephone Number	:	541-475-2020

Provider Enumeration Date	:	01/07/2008
Last Update Date	:	07/01/2010

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