Individual
JARED A DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1304 MILITARY RD, BENTON, AR 72015-2911
(501) 778-0934
(501) 778-1013
Mailing address
1304 MILITARY RD, BENTON, AR 72015-2911
(501) 778-0934
(501) 778-1013
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E7567
AR
207QS0010X
Sports Medicine (Family Medicine) Physician
E7567
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194201001
—
AR
Enumeration date
09/15/2008
Last updated
02/13/2020
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