Individual
RUSSELL DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5950 UNIVERSITY AVE STE 105, WEST DES MOINES, IA 50266-7756
(515) 875-9070
(515) 875-9071
Mailing address
1001 PENNSYLVANIA AVE, OTTUMWA, IA 52501-6427
(641) 684-2402
(641) 684-2401
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
002215
IA
363AS0400X
Surgical Physician Assistant
Primary
002215
IA
Other
Enumeration date
07/11/2011
Last updated
08/17/2021
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