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Individual

DR. WILLIAM RUSSELL NIXON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
300 E MAPLE RD, SUITE 323, BIRMINGHAM, MI 48009-6308
(248) 644-7368
(248) 644-2901
Mailing address
300 E MAPLE RD, SUITE 323, BIRMINGHAM, MI 48009-6308
(248) 644-7368
(248) 644-2901

Taxonomy

Speciality
Code
Description
License number
State
103TP0814X
Psychoanalysis Psychologist
Primary
002567
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0N60160
MEDICARE PROVIDER NUMBER
MI
01
0N60160
MEDICARE PROVIDER NUMBER
MP
Enumeration date
06/04/2008
Last updated
06/04/2008
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