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Individual

KEITH ALAN DIXON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4509 E MCCAIN BLVD, NORTH LITTLE ROCK, AR 72117-2902
(501) 945-8080
(501) 945-5040
Mailing address
4509 EAST MCCAIN BLDV, NORTH LITTLE ROCK, AR 72117
(501) 945-8080
(501) 945-5040

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
R3514
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
042548
MEDICARE PART A
AR
01
1238100005
QUALCHOICE
AR
01
3120013
UNITED HEALTH CARE
AR
01
51377
BLUE CROSS BLUE SHIELD
AR
Enumeration date
09/13/2006
Last updated
07/08/2007
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