Organization
JERRY W. DIXON, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY W. DIXON M.D. (OWNER)
(501) 778-3361
Entity
Organization
Contact information
Practice address
3 MEDICAL PARK DR, SUITE 201, BENTON, AR 72015-3728
(501) 778-3361
(501) 778-3135
Mailing address
3 MEDICAL PARK DR, SUITE 201, BENTON, AR 72015-3728
(501) 778-3361
(501) 778-3135
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
E0176
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125732001
—
AR
Enumeration date
03/15/2007
Last updated
10/28/2011
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