| Doctor Name: | WILLIAM L WIXOM |
| NPI Number: | 1578594933 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | 02001810A |
| Business Practice Address: | 1000 S Main St Tipton, IN - 460729753 |
| Business Phone Number: | 7656758397 |
| Business Fax Number: | 7656756704 |
| Mailing Address: | 250 N Shadeland Ave, Suite 130 INDIANAPOLIS |
| State: | IN |
| Postal Code: | 462194959 |
| Phone Number: | 3179207195 |
| Fax Number: | |
| NPI Enumeration Date: | 07/05/2006 |
| NPI Last Update Date: | 04/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 02001810A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |