DIXON FAMILY PRACTICE AND INTERNAL MEDICINE, LLC


Address: 206 West 2nd Street, Dixon, MO 65459-0940
Phone: 5737593030

DIXON FAMILY PRACTICE AND INTERNAL MEDICINE, LLC (NPI# 1235135682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1235135682
Entity Type Organization
Organization Name DIXON FAMILY PRACTICE AND INTERNAL MEDICINE, LLC
Practice Address 206 West 2nd Street
Dixon
MO 65459-0940
Mailing Address Po Box 9900
Dixon
MO 65459-0940
Practice Telephone 5737593030
Practice Fax Number 5737593131
Mailing Telephone 5737593030
Mailing Fax Number 5737593131
Enumeration Date 2005-06-21
Last Update Date 2008-04-29
Authorized Official Name CARLENE S MCMILLIAN (OWNER)
Authorized Official Telephone 5737593030
Authorized Official Credential FNP
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207Q00000X Family Medicine R6D44 MO Allopathic & Osteopathic Physicians
N 363LF0000X Nurse Practitioner
Specialization: Family
113217 MO Physician Assistants & Advanced Practice Nursing Providers
Y 261QR1300X Clinic/Center
Specialization: Rural Health
263875 MO Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MO 598937001 05
MO 508937000 05

Office Location

Street Address 206 WEST 2ND STREET
City DIXON
State MO
Zip Code 65459-0940

Providers in the same location

NPI Name Taxonomy Address Enumeration
1134282429 Hometown Pharmacy Pharmacy 206 West 2nd Street, Dixon, MO 65459-0220 2006-12-18

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1205091139 William Edward Colyer Family Medicine Hwy 28 100 E. 5th Street, Dixon, MO 65459 2008-07-21
1770621542 Dixon Ambulance District Ambulance 305 S. Ellen St., Dixon, MO 65459 2007-02-02
1114077864 Brenda Joy Fricke Counselor 402 S Elm, Box 798, Dixon, MO 65459 2007-01-12
1124152855 Romar Gianan Milos Physical Therapist 106 West Fourth Street, Dixon, MO 65459-0166 2007-03-15
1255471587 Dixon Reorganized Dist R1 Physical Therapist 106 W Fourth St, Dixon, MO 65459-0166 2007-02-07
1992997852 Yvette Labajo Jakosalem Occupational Therapist 106 W Fourth St, Dixon Reorgaized Distr R-1, Dixon, MO 65459-0166 2007-08-15
1316070444 Julia Clodius Cooke Speech-Language Pathologist 106 W Fourth St, Box A, Dixon, MO 65459-0166 2007-03-14
1164427324 Carlene S Mcmillian Nurse Practitioner 206 W. 2nd Street, Dixon, MO 65459-0940 2005-06-15
1285817361 Denise Lorenz Counselor 402 South Elm St, Dixon, MO 65459-6004 2007-12-11
1568906162 Daniel Draper Contractor 515 Andrews Ave, Dixon, MO 65459-6010 2016-12-15
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Taxonomy Information

Taxonomy Code 261QR1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rural Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1871102137 Washington County Memorial Hospital Clinic/Center 14206 Hwy C, Belgrade, MO 63622 2020-07-23
1891325072 Scotland County Memorial Hospital Clinic/Center 55682 State Highway 6 Ste A, Edina, MO 63537-4268 2020-01-16
1639736457 Southeast Health Center of Stoddard County LLC Clinic/Center 800 Us Highway 61, New Madrid, MO 63869-1106 2019-05-28
1134633456 Pike County Memorial Hospital Clinic/Center 1420 S Business 61 Unit Fde, Bowling Green, MO 63334-5230 2017-11-22
1720505894 Perry County Health System Clinic/Center 210 Hospital Ln Ste 202, Perryville, MO 63775-4200 2017-08-29
1427572007 Missouri Delta Medical Center Clinic/Center 209 W Yoakum Ave, Chaffee, MO 63740-1138 2017-07-26
1790213676 Jackson Primary Care LLC Clinic/Center 2685 E Main St Ste A, Jackson, MO 63755-2474 2017-05-23
1972050581 Sgoh Acquisition, Inc. Clinic/Center 912b State Highway 59, Goodman, MO 64843-8252 2016-09-01
1144605312 Nevada City Hospital Clinic/Center 627 S Ash St Ste B, Nevada, MO 64772 2015-07-29
1669856829 Ssm Regional Health Services Clinic/Center 2511 W Edgewood Dr Ste F, Jefferson City, MO 65109-5869 2015-07-16
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Competitor

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City DIXON
Zip Code 65459

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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