Individual
PAUL T DIXON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CP
Contact information
Practice address
4205 CHESTNUT TRL, COHUTTA, GA 30710-9375
(859) 609-7153
Mailing address
4205 CHESTNUT TRL, COHUTTA, GA 30710-9375
(859) 609-7153
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
CPO03648
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518526
—
TN
Enumeration date
05/20/2011
Last updated
06/21/2012
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