Individual
DR. MARK DALE DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1395 S PINELLAS AVE, TARPON SPRINGS, FL 34689-3790
(813) 972-4199
(813) 972-5753
Mailing address
12479 TELECOM DR, TAMPA, FL 33637-0913
(813) 972-4199
(813) 972-5753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME63074
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254054100
—
FL
01
—
43116
BCBS OF FLORIDA
FL
Enumeration date
05/26/2006
Last updated
10/02/2014
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