# DIXON FAMILY PRACTICE AND INTERNAL MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235135682
- **Authorized official:** CARLENE S MCMILLIAN FNP (OWNER)
- **Authorized official phone:** (573) 759-3030

## Contact information

- **Practice address:** 206 WEST 2ND STREET, DIXON, MO 65459-0940
- **Practice address phone:** (573) 759-3030
- **Practice address fax:** (573) 759-3131
- **Mailing address:** PO BOX 9900, DIXON, MO 65459-0940
- **Mailing address phone:** (573) 759-3030
- **Mailing address fax:** (573) 759-3131

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | R6D44 | MO | — |
| 261QR1300X | Rural Health Clinic/Center | 263875 | MO | Yes |
| 363LF0000X | Family Nurse Practitioner | 113217 | MO | — |

## Other

- **Enumeration date:** 06/21/2005
- **Last updated:** 04/29/2008