Doctor Name: | DR. BRENNER F DIXON |
NPI Number: | 1720239528 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | TL2878 |
Business Practice Address: | 2373 G Rd Grand Junction, CO - 815051002 |
Business Phone Number: | 9702439340 |
Business Fax Number: | 9702416894 |
Mailing Address: | Po Box 1687, GRAND JUNCTION |
State: | CO |
Postal Code: | 815021687 |
Phone Number: | 9702566322 |
Fax Number: | 9702632691 |
NPI Enumeration Date: | 10/10/2008 |
NPI Last Update Date: | 12/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | TL2878 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |