Provider Demographics
NPI:1174643027
Name:WEISS, DIXIE M (RPH)
Entity type:Individual
Prefix:
First Name:DIXIE
Middle Name:M
Last Name:WEISS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 HIGHLAND ACRES RD
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-2372
Mailing Address - Country:US
Mailing Address - Phone:319-277-1188
Mailing Address - Fax:
Practice Address - Street 1:1702 S CENTER ST
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-4258
Practice Address - Country:US
Practice Address - Phone:641-752-4685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18935183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist