Organization
BARRETT PARKWAY FOOT AND LEG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL WADE DIXON DPM (PRESIDENT CEO)
(770) 422-0280
Entity
Organization
Contact information
Practice address
440 ERNEST W BARRETT PKWY NW, STE 62, KENNESAW, GA 30144-4918
(770) 042-2028
(770) 426-5388
Mailing address
440 ERNEST W BARRETT PKWY NW, STE 62, KENNESAW, GA 30144-4918
(770) 042-2028
(770) 426-5388
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
GA000961
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000954643C
—
GA
Enumeration date
06/28/2005
Last updated
01/14/2014
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