Provider Demographics
NPI:1750528428
Name:CHRISTINA J DIXON OD PC
Entity type:Organization
Organization Name:CHRISTINA J DIXON OD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:540-720-0407
Mailing Address - Street 1:120 SOARING EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-3903
Mailing Address - Country:US
Mailing Address - Phone:540-720-0407
Mailing Address - Fax:540-720-9047
Practice Address - Street 1:120 SOARING EAGLE DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-3903
Practice Address - Country:US
Practice Address - Phone:540-720-0407
Practice Address - Fax:540-720-9047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000817152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty