Provider Demographics
NPI:1952162356
Name:DIXON, PARIS LASHAWN
Entity Type:Individual
Prefix:
First Name:PARIS
Middle Name:LASHAWN
Last Name:DIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5290 GATEHOUSE DR APT H
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2572
Mailing Address - Country:US
Mailing Address - Phone:614-705-5541
Mailing Address - Fax:
Practice Address - Street 1:5290 GATEHOUSE DR
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-2572
Practice Address - Country:US
Practice Address - Phone:614-705-5541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker