Organization
JEROME A. DIXON, D.O., LLC
Active
Other names
Jerome A. Dixon, D.O., P.S.C., Jerome A. Dixon, D.O., P.S.C.
Organization subpart
No
Provider details
NPI number
Authorized official
NISSAN FRIEDMAN (CHIEF EXECUTIVE OFFICER)
(845) 521-9991
Entity
Organization
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
207Q00000X
Family Medicine Physician
Primary
02320
KY
363LF0000X
Family Nurse Practitioner
3007692
KY
363LF0000X
Family Nurse Practitioner
4091P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64023203
—
KY
Enumeration date
11/28/2006
Last updated
02/24/2026
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