Dixon, Tara J

Dixon, Tara J is an individual health care provider with primary practice located at 5569 Houston Rd , Macon GA 31216-5709. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Dixon, Tara J can be contacted via phone (478) 781-5065.

Contact Information

Primary practice address
5569 Houston Rd Macon GA 31216-5709
Phone: (478) 781-5065
Fax: (478) 781-0012
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN159360 Georgia

Profile Details

NPI number 1598956120
LBN Legal business name Dixon, Tara J
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 8th, 2007
Last updated Feb 9th, 2022 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598956120 NPPES
Georgia Other P00475216 RR MEDICARE

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