Nixon, John Randall

Nixon, John Randall is an individual health care provider with primary practice located at 3623 Latrobe Dr Ste 216, Charlotte NC 28211-1187. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Medicine, Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Nixon, John Randall can be contacted via phone (704) 332-1291.

Contact Information

Primary practice address
3623 Latrobe Dr Ste 216 Charlotte NC 28211-1187
Phone: (704) 332-1291
Fax: (704) 332-5206
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nuclear Medicine 207U00000X 31602 North Carolina
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X 31602 North Carolina
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 31602 North Carolina

Profile Details

NPI number 1679533707
LBN Legal business name Nixon, John Randall
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Sep 12th, 2020 - about 4 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 1679533707 NPPES
South Carolina MEDICAID N31602
South Carolina MEDICAID 8962689

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