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Individual

MS. VICKI DISHON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MHS, PA-C

Contact information

Practice address
1234 E DUPONT RD STE 3, FORT WAYNE, IN 46825-1545
(260) 672-6590
(260) 672-6599
Mailing address
3702 NEW VISION DR, BLDG B, FORT WAYNE, IN 46845-1703
(614) 777-5700
(614) 777-5777

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002438A
IN
363A00000X
Physician Assistant
50.001964
OH

Other

Enumeration date
04/15/2008
Last updated
07/22/2019
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