Organization Active NPI

Dixophthal PC

  • Ophthalmic Technician/Technologist
  • Albany, GA
National Provider Identifier
1801956909
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Technician/TechnologistTaxonomy code 156FX1100X
License
040367 Issued in GA
Legal business name
DIXOPHTHAL PC
Practice address
806 N Jefferson St
Albany, GA 31701-2363
Phone
(229) 439-7700
Fax
(229) 439-7283
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. El-Roy Dec Dixon, M.D.
Title
Owner
Phone
(229) 439-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Technician/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1100X 040367 GA Primary

Addresses

Primary practice location

806 N Jefferson St
Albany, GA 31701-2363

Mailing address

PO Box 71445
Albany, GA 31708-1445
Phone (229) 439-7700

Other identifiers 3

IdentifierTypeStateIssuer
000656719HMedicaidGA
000656719JMedicaidGA
000656719IMedicaidGA

National Provider Directory

National Provider Directory

Locations

806 N Jefferson St
Albany, GA 31701
Phone (229) 439-7700

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1801956909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71445",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317081445",
            "telephone_number": "229-439-7700",
            "fax_number": "229-439-7283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 N JEFFERSON ST",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317012363",
            "telephone_number": "229-439-7700",
            "fax_number": "229-439-7283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIXOPHTHAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "EL-ROY",
        "authorized_official_middle_name": "DEC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-439-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "156FX1100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": "GA",
            "license": "040367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000656719H",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000656719J",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000656719I",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.