Provider Demographics
NPI:1528016805
Name:NIXON, CHRISTA S (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:S
Last Name:NIXON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ADAMS AVE
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36104-4424
Mailing Address - Country:US
Mailing Address - Phone:334-263-2301
Mailing Address - Fax:334-263-0881
Practice Address - Street 1:5422 STATE HIGHWAY 94
Practice Address - Street 2:
Practice Address - City:RAMER
Practice Address - State:AL
Practice Address - Zip Code:36069-5008
Practice Address - Country:US
Practice Address - Phone:334-562-3229
Practice Address - Fax:334-562-9060
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00025930207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51526931OtherBCBS
ALH71956Medicare UPIN