Organization
NORTHWEST NEPHROLOGY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW A DIXON M.D. (PHYSICIAN)
(770) 981-2211
Entity
Organization
Contact information
Practice address
5255 SNAPFINGER PARK DR, SUITE 110, DECATUR, GA 30035-4084
(770) 981-2211
Mailing address
5255 SNAPFINGER PARK DR, SUITE 110, DECATUR, GA 30035-4084
(770) 981-2211
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
028761
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000441306E
—
GA
05
—
000702281G
—
GA
05
—
103863411A
—
GA
05
—
103863411B
—
GA
05
—
300030041B
—
GA
Enumeration date
03/20/2007
Last updated
03/08/2023
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