Provider Demographics
NPI:1114009305
Name:DIXON, FERRELL AL JR (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:FERRELL
Middle Name:AL
Last Name:DIXON
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2409 US HIGHWAY 17
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-3756
Mailing Address - Country:US
Mailing Address - Phone:912-756-3331
Mailing Address - Fax:912-756-5904
Practice Address - Street 1:2409 US HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-3756
Practice Address - Country:US
Practice Address - Phone:912-756-3331
Practice Address - Fax:912-756-5904
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA 13804183500000X
GA13804183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist