Individual
DRUERY J DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
181 N KENTUCKY AVE, SUITE 100, WEST PLAINS, MO 65775-2089
(417) 257-5911
(417) 257-5913
Mailing address
181 N KENTUCKY AVE, SUITE 100, WEST PLAINS, MO 65775-2089
(417) 257-5911
(417) 257-5913
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
E4127
AR
207Q00000X
Family Medicine Physician
Primary
R8G07
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121380001
ARKANSAS MEDICAID
AR
01
—
16390
BCBS PROVIDER NUMBER
MO
05
—
202386926
—
MO
Enumeration date
08/31/2006
Last updated
09/11/2012
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