Provider Demographics
NPI:1043404874
Name:JAMES R. DIXON, II D.O.
Entity Type:Organization
Organization Name:JAMES R. DIXON, II D.O.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:II
Authorized Official - Credentials:DO
Authorized Official - Phone:251-368-2346
Mailing Address - Street 1:410 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:ATMORE
Mailing Address - State:AL
Mailing Address - Zip Code:36502-3016
Mailing Address - Country:US
Mailing Address - Phone:251-368-2346
Mailing Address - Fax:251-368-3557
Practice Address - Street 1:410 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:ATMORE
Practice Address - State:AL
Practice Address - Zip Code:36502-3016
Practice Address - Country:US
Practice Address - Phone:251-368-2346
Practice Address - Fax:251-368-3557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO 391208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty