Individual
MICHAEL WESLEY DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
4008 BUCHANAN DR, HAMPTON, VA 23669-4608
(850) 691-7387
Mailing address
4008 BUCHANAN DR, HAMPTON, VA 23669-4608
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
10/24/2017
Last updated
10/24/2017
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