| Doctor Name: | DR. JIMMY L DIXON |
| NPI Number: | 1053613877 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D., F.A.C.S. |
| License Number: | 13027 |
| Business Practice Address: | 101 Virginia St St Simons Island, GA - 315225129 |
| Business Phone Number: | 9126388139 |
| Business Fax Number: | |
| Mailing Address: | 101 Virginia St, ST SIMONS ISLAND |
| State: | GA |
| Postal Code: | 315225129 |
| Phone Number: | 9126388139 |
| Fax Number: | |
| NPI Enumeration Date: | 11/30/2010 |
| NPI Last Update Date: | 11/30/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 13027 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |