Individual
BLAKE DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
350 HOSPITAL WAY STE 100, SOMERSET, KY 42503-1872
(606) 451-2600
(606) 451-2651
Mailing address
111 JUSTICE WAY APT 409, PIKEVILLE, KY 41501-8314
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R5030
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2019
Last updated
06/08/2022
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