Provider Demographics
NPI:1992978837
Name:JOHN M DIXON MD PC
Entity type:Organization
Organization Name:JOHN M DIXON MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-439-7774
Mailing Address - Street 1:1909 ABERDEEN ROAD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1300
Mailing Address - Country:US
Mailing Address - Phone:229-439-7774
Mailing Address - Fax:229-883-8586
Practice Address - Street 1:1909 ABERDEEN ROAD
Practice Address - Street 2:SUITE 108
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1300
Practice Address - Country:US
Practice Address - Phone:229-439-7774
Practice Address - Fax:229-883-8586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0664660001Medicare NSC