Provider Demographics
NPI:1982893442
Name:HAMILTON S. DIXON, M.D. P.C.
Entity type:Organization
Organization Name:HAMILTON S. DIXON, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE MNGR
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:O
Authorized Official - Last Name:HENDRIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-235-4411
Mailing Address - Street 1:3268 MARTHA BERRY HWY NE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-7712
Mailing Address - Country:US
Mailing Address - Phone:706-235-4411
Mailing Address - Fax:706-232-3561
Practice Address - Street 1:3268 MARTHA BERRY HWY NE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-7712
Practice Address - Country:US
Practice Address - Phone:706-235-4411
Practice Address - Fax:706-232-3561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD39752Medicare UPIN