Provider Demographics
NPI:1154305084
Name:DIXON, ANTHEA J (MD)
Entity Type:Individual
Prefix:
First Name:ANTHEA
Middle Name:J
Last Name:DIXON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:5190 E FARNESS DR
Mailing Address - Street 2:#106
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2142
Mailing Address - Country:US
Mailing Address - Phone:520-323-3103
Mailing Address - Fax:520-327-8999
Practice Address - Street 1:5190 E FARNESS DR
Practice Address - Street 2:#106
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2142
Practice Address - Country:US
Practice Address - Phone:520-323-3103
Practice Address - Fax:520-327-8999
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZW202207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E00258Medicare UPIN