Organization
JUSTIN K DIXON MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN K DIXON MD (OWNER)
(606) 324-4404
Entity
Organization
Contact information
Practice address
336 29TH ST, SUITE 101, ASHLAND, KY 41101-1900
(606) 324-4404
(606) 325-6822
Mailing address
336 29TH ST, SUITE 101, ASHLAND, KY 41101-1900
(606) 324-4404
(606) 325-6822
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
46135
KY
363A00000X
Physician Assistant
—
KY
363AS0400X
Surgical Physician Assistant
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0102360
—
OH
Enumeration date
04/30/2014
Last updated
09/11/2014
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