DIXIE A. FULLERTON; NPI #1336296979

Contact Information

DIXIE A. FULLERTON

1618 E CHARLESTON BLVD
LAS VEGAS, NV 89104-1826

Phone: 702-384-5121
Fax: 702-384-4416
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Prosthetic/Orthotic Supplier	335E00000X	51	Medical Supply Company with Orthotist

Indicates primary specialty

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NPI Profile & details for DIXIE A. FULLERTON

NPI # 1336296979

LBN Legal business name DIXIE A. FULLERTON

Authorized official DIXIE FULLERTON - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 01/05/2007

Last updated 07/23/2012 - About 14 years ago

Identifiers

Medicaid

003302425

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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DIXIE A. FULLERTON

Contact Information

Specialty

Prosthetic/Orthotic Supplier

NPI Profile & details for DIXIE A. FULLERTON

Reviews for DIXIE A. FULLERTON