# DIXON FAMILY MEDICAL CENTER, LLC

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

## Provider details

- **NPI number:** 1366847337
- **Authorized official:** MONIQUE BIANCA DECLOUET-DIXON FNP (FAMILY NURSE PRACTITIONER)
- **Authorized official phone:** (337) 628-5014

## Contact information

- **Practice address:** 536 ST. LANDRY VETERANS MEMORIAL HWY., WASHINGTON, LA 70589-4420
- **Practice address phone:** (337) 628-5014
- **Practice address fax:** (337) 826-5401
- **Mailing address:** PO BOX 596, WASHINGTON, LA 70589-0596
- **Mailing address phone:** (337) 628-5014
- **Mailing address fax:** (337) 826-5401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | AP05959 | LA | Yes |

## Other

- **Enumeration date:** 11/03/2014
- **Last updated:** 09/18/2015