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Contact Information

BRIAN R DIX, DO
15190 COMMUNITY RD
SUITE 230A
GULFPORT, MS39503-3485
 Phone: 228-831-0204
 Fax: 228-831-1868
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for BRIAN R DIX · (Male)

NPI # 1932215464
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 08/21/2006
Last updated 11/09/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • IN License # 02001248A
  • MS License # 13810
  • MS Medicaid 00113498
Hospital affiliation(s)
  • MEMORIAL HOSPITAL AT GULFPORT - (Acute Care)
    4500 13TH ST-P O BOX 1810
    GULFPORT, MS 39502
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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