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Individual

DR. JAMES GRAYSON DIXON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
825 FAIRFAX AVE, NORFOLK, VA 23507-1914
(757) 446-5955
(757) 446-5196
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 446-5955
(757) 446-5196

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101034661
VA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
0101034661
VA
207R00000X
Internal Medicine Physician
Primary
01010343661
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
-002 -003
TRICARE/CHAMPUS
VA
05
005612829
VA
05
006026001
VA
01
0516K
BC/BS
NC
01
12095
SENTARA OPTIMA
VA
01
227456
UHC/MAMSI
VA
01
332674
ANTHEM
VA
05
890516K
NC
01
PAR
FIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA
Enumeration date
02/13/2006
Last updated
11/25/2009
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