Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 1038 | MA |
NPI | 1043296726 |
---|---|
Provider Name | Dr. Brian Scott Dixon |
First Address | Springfield, MA 01109-1709 |
Second Address | Springfield, MA 01109-1709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 24/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
050001038 | CONNECTICUT BC/BS (01) | MA |
0554418 | AETNA (01) | MA |
1604252 | (05) | MA |
5823070002 | CIGNA (01) | MA |
705823 | CONNECTICARE (01) | MA |
T58353 | (02) | MA |