Provider Demographics
NPI:1588909634
Name:NIXON, TOM (DC)
Entity type:Individual
Prefix:DR
First Name:TOM
Middle Name:
Last Name:NIXON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:THOMAS
Other - Middle Name:
Other - Last Name:NIXON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:3288 ROBINHOOD RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-5464
Mailing Address - Country:US
Mailing Address - Phone:386-214-5444
Mailing Address - Fax:
Practice Address - Street 1:3288 ROBINHOOD RD STE 101
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-5464
Practice Address - Country:US
Practice Address - Phone:386-214-5444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34973928111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor