Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. TY-RE LAMONT DIXON SR.
Active Sole ProprietorMR. TY-RE LAMONT DIXON SR. is a Customized Equipment (DME) healthcare provider located in FAYETTEVILLE, Georgia. NPI 1902264492 is currently active in the NPPES registry. Verify at CMS.
Customized Equipment (DME) · FAYETTEVILLE, GA
Registration Details
- NPI Number
- 1902264492
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 29, 2016 (10.547874285737 yrs)
- Last Updated
- Jan 29, 2016
- Sole Proprietor
- Yes
Practice Information
- Address
-
220 SHORELINE DR.FAYETTEVILLE, GA, 30215Browse GA providers · Browse ZIP 30215
- Phone
- 4046611800
- Fax
- 7708973777
- Primary Specialty
-
Customized Equipment (DME)
332BC3200X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.