Provider Demographics
NPI:1164400412
Name:HIXSON, MARCIA L (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:L
Last Name:HIXSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3470 LANDERS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2541
Mailing Address - Country:US
Mailing Address - Phone:501-945-0661
Mailing Address - Fax:501-945-0621
Practice Address - Street 1:3470 LANDERS RD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2541
Practice Address - Country:US
Practice Address - Phone:501-945-0661
Practice Address - Fax:501-945-0621
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC5658174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR105343001Medicaid
AR53059C207OtherMEDIARE
AR105343001Medicaid
AR5AA05G344Medicare UPIN
AR53059Medicare ID - Type Unspecified
AR5G344Medicare PIN
AR200031253Medicare PIN