Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | ME91725 | FL |
Y | 2080P0210X | Pediatric Nephrologist | 21228 | MS |
N | 2080P0210X | Pediatric Nephrologist | ME91725 | FL |
NPI | 1558397299 |
---|---|
Provider Name | Mr. Mehul P Dixit |
First Address | Jackson, MS 39216-4500 |
Second Address | Jackson, MS 39216-4500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2006 |
Last Update Date | 20/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07933347 | (05) | MS |
271724700 | (05) | FL |
52242 | BCBS (01) | FL |
H07932 | (02) |