Individual
MR. JEROME ANTHONY DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
150 W BEAR TRACK RD, CAMPBELLSVILLE, KY 42718-8709
(270) 465-8133
(270) 789-1543
Mailing address
150 W BEAR TRACK RD, CAMPBELLSVILLE, KY 42718-8709
(270) 465-8133
(270) 789-1543
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
02320
KY
207Q00000X
Family Medicine Physician
Primary
02320
KY
207QA0401X
Addiction Medicine (Family Medicine) Physician
02320
KY
207QG0300X
Geriatric Medicine (Family Medicine) Physician
02320
KY
2083X0100X
Occupational Medicine Physician
02320
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64023203
—
KY
Enumeration date
11/15/2005
Last updated
12/14/2009
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