Individual
JOHN EDWARD DIZON
Active
Individual
JOHN EDWARD DIZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
J4087
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2337424
—
LA
01
—
8K7239
BLUE SHIELD
TX
01
—
P00196482
RAILROAD MEDICARE
TX
Enumeration date
01/09/2007
Last updated
09/10/2020
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