Provider Demographics
NPI:1609653575
Name:DIXON, YOLANDA E (PHLEBOTOMY)
Entity Type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:E
Last Name:DIXON
Suffix:
Gender:F
Credentials:PHLEBOTOMY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 SWEETWATER RD APT 312
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-6565
Mailing Address - Country:US
Mailing Address - Phone:203-338-1389
Mailing Address - Fax:
Practice Address - Street 1:3350 SWEETWATER RD APT 312
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-6565
Practice Address - Country:US
Practice Address - Phone:203-338-1389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA397235181202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Single Specialty