Provider Demographics
NPI:1114915246
Name:DIXON, ROBERT MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARK
Last Name:DIXON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1260
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-1260
Mailing Address - Country:US
Mailing Address - Phone:623-856-9717
Mailing Address - Fax:623-856-4674
Practice Address - Street 1:7219 N LITCHFIELD RD
Practice Address - Street 2:56TH MDOS/SGOSGS
Practice Address - City:LUKE AFB
Practice Address - State:AZ
Practice Address - Zip Code:85309-1529
Practice Address - Country:US
Practice Address - Phone:632-856-9717
Practice Address - Fax:623-856-4674
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2011-11-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ34167208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery