Individual
BRADLEY S DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 W FOREST MEADOWS ST STE 18, FLAGSTAFF, AZ 86001-3601
(602) 230-7373
(928) 260-9970
Mailing address
3101 N CENTRAL AVE STE 550, PHOENIX, AZ 85012-2635
(602) 230-7373
(602) 682-7455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
27723
IA
207R00000X
Internal Medicine Physician
Primary
7875
AZ
207RN0300X
Nephrology Physician
27723
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00252
WELLMARK BCBS
IA
05
—
0065268
—
IA
Enumeration date
11/14/2005
Last updated
03/31/2026
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