Provider Demographics
NPI:1770874695
Name:NIX, ANTHONY JEROME JR (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JEROME
Last Name:NIX
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:315 W HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-2913
Mailing Address - Country:US
Mailing Address - Phone:256-207-0209
Mailing Address - Fax:
Practice Address - Street 1:209 W SPRING ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-2973
Practice Address - Country:US
Practice Address - Phone:256-401-4686
Practice Address - Fax:256-401-4694
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALL.3478R207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine