Dixon, Mark Dale

Dixon, Mark Dale is an individual health care provider with primary practice located at 1395 S Pinellas Ave , Tarpon Springs FL 34689-3790. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Dixon, Mark Dale can be contacted via phone (813) 972-4199.

Contact Information

Primary practice address
1395 S Pinellas Ave Tarpon Springs FL 34689-3790
Phone: (813) 972-4199
Fax: (813) 972-5753
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X ME63074 Florida

Profile Details

NPI number 1245286400
LBN Legal business name Dixon, Mark Dale
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2006
Last updated Oct 2nd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245286400 NPPES
Florida MEDICAID 254054100
Florida Other 43116

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