Provider Demographics
NPI:1174646723
Name:DIXON, KAREN (CSA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DIXON
Suffix:
Gender:F
Credentials:CSA
Other - Prefix:
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Mailing Address - Street 1:PO BOX 960843
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30296-0843
Mailing Address - Country:US
Mailing Address - Phone:678-499-5103
Mailing Address - Fax:770-629-5554
Practice Address - Street 1:325 FIELDSTONE PKWY
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-7502
Practice Address - Country:US
Practice Address - Phone:678-499-5103
Practice Address - Fax:770-629-5554
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2010-02-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA2900363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical