Dixon, Jaimen L.
Dixon, Jaimen L. is an individual health care provider with primary practice located at 700 N Raymond St , Boise ID 83704-9261. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Dixon, Jaimen L. can be contacted via phone (208) 375-3871.Contact Information
Primary practice address
700 N Raymond St
Boise ID 83704-9261
Phone: (208) 375-3871
Fax: (406) 222-8419
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | ODP-100399 | Idaho |
| Eye and Vision Services Providers / Optometrist | 152W00000X | ODP-100399 | Idaho |
Profile Details
| NPI number | 1861841033 |
|---|---|
| LBN Legal business name | Dixon, Jaimen L. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2016 |
| Last updated | Aug 4th, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861841033 | NPPES |
| Idaho | MEDICAID | 1861841033 |
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