Individual
BYRON DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1113 SANDFORT RD, PHENIX CITY, AL 36867-6651
(334) 408-4355
Mailing address
1113 SANDFORT RD, PHENIX CITY, AL 36867-6651
(404) 683-8776
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47-5495087
IRS
AL
Enumeration date
12/14/2015
Last updated
04/27/2016
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