Dixon Family Medical Center, LLC

Organization Active NPI Rural Health Clinic/Center · Washington, LA

NPI 1366847337 · NPPES record last updated Sep 18, 2015

Key facts

NPI
1366847337
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
License
AP05959 (LA)
Legal business name
DIXON FAMILY MEDICAL CENTER, LLC
Practice address
536 St. Landry Veterans Memorial Hwy.
Washington, LA 70589-4420
Phone
(337) 628-5014
Fax
(337) 826-5401
NPI assigned
Nov 3, 2014
Organization subpart
No

Authorized official

Name
Monique Bianca Declouet-Dixon, FNP
Title
Family Nurse Practitioner
Phone
(337) 628-5014

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X AP05959 LA Yes

Addresses

Primary practice location

536 St. Landry Veterans Memorial Hwy.
Washington, LA 70589-4420

Mailing address

PO Box 596
Washington, LA 70589-0596
Phone (337) 628-5014

Other identifiers

IdentifierTypeStateIssuer
1820105MedicaidLA

Other providers in Washington, LA

All providers in Washington, LA · Rural Health Clinic/Center in Louisiana

Sources for this page

Verify at the official NPI Registry.