Provider Demographics
NPI:1255304416
Name:DIXON, RITU V (MD)
Entity Type:Individual
Prefix:
First Name:RITU
Middle Name:V
Last Name:DIXON
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 1:10623 PROFESSIONAL CIRCLE
Mailing Address - Street 2:SUITE B
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-5831
Mailing Address - Country:US
Mailing Address - Phone:775-850-1188
Mailing Address - Fax:775-850-1189
Practice Address - Street 1:10623 PROFESSIONAL CIRCLE
Practice Address - Street 2:SUITE B
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5831
Practice Address - Country:US
Practice Address - Phone:775-850-1188
Practice Address - Fax:775-850-1189
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10691207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVP00131654OtherRAILROAD MEDICARE
NVI08321Medicare UPIN
NV39524Medicare ID - Type Unspecified
NV103238Medicare PIN