Individual
MARLA TEAT DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2324 LIMESTONE OVERLOOK, GAINESVILLE, GA 30501-7443
(770) 536-8109
(770) 536-3203
Mailing address
2324 LIMESTONE OVERLOOK, GAINESVILLE, GA 30501-7443
(770) 536-8109
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
004138
GA
363AM0700X
Medical Physician Assistant
Primary
004138
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
654547969A
—
GA
Enumeration date
01/09/2007
Last updated
01/07/2021
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