# JEROME A DIXON D O LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jerome A. Dixon, D.O., P.S.C., Jerome A. Dixon, D.O., P.S.C.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508932955
- **Authorized official:** NISSAN FRIEDMAN (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (845) 521-9991

## Contact information

- **Practice address:** 150 W BEAR TRACK RD, CAMPBELLSVILLE, KY 42718-8709
- **Practice address phone:** (270) 465-8133
- **Practice address fax:** (270) 789-1543
- **Mailing address:** 150 W BEAR TRACK RD, CAMPBELLSVILLE, KY 42718-8709
- **Mailing address phone:** (270) 465-8133
- **Mailing address fax:** (270) 789-1543

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 02320 | KY | Yes |
| 363LF0000X | Family Nurse Practitioner | 3007692 | KY | — |
| 363LF0000X | Family Nurse Practitioner | 4091P | KY | — |

## Other

- **Enumeration date:** 11/28/2006
- **Last updated:** 05/20/2026