Individual
LESLIE M DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 17TH ST, COLUMBUS, IN 47201-5351
(812) 379-4441
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 765-3153
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/07/2024
Last updated
11/22/2024
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