# JUSTIN K DIXON MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043620024
- **Authorized official:** JUSTIN K DIXON MD (OWNER)
- **Authorized official phone:** (606) 324-4404

## Contact information

- **Practice address:** 336 29TH ST, SUITE 101, ASHLAND, KY 41101-1900
- **Practice address phone:** (606) 324-4404
- **Practice address fax:** (606) 325-6822
- **Mailing address:** 336 29TH ST, SUITE 101, ASHLAND, KY 41101-1900
- **Mailing address phone:** (606) 324-4404
- **Mailing address fax:** (606) 325-6822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 46135 | KY | Yes |
| 363A00000X | Physician Assistant | — | KY | — |
| 363AS0400X | Surgical Physician Assistant | — | KY | — |

## Other

- **Enumeration date:** 04/30/2014
- **Last updated:** 09/11/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0102360 | — | OH |