Provider Demographics
NPI:1407806730
Name:DIXON, JOHN E (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:DIXON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CAMANCHE
Mailing Address - State:IA
Mailing Address - Zip Code:52730-2003
Mailing Address - Country:US
Mailing Address - Phone:563-259-8015
Mailing Address - Fax:
Practice Address - Street 1:1429 3RD ST
Practice Address - Street 2:
Practice Address - City:CAMANCHE
Practice Address - State:IA
Practice Address - Zip Code:52730-2003
Practice Address - Country:US
Practice Address - Phone:563-259-8015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20089207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA20311OtherWELLMARK BC/BS
018411OtherHEALTH ALLIANCE
IA0188680Medicaid
IA0114OtherJOHN DEERE HEALTH
IL0180373033Medicaid
18988OtherMIDLANDS CHOICE
27075OtherIOWA HEALTH SOLUTIONS
018411OtherHEALTH ALLIANCE
IA20311Medicare PIN
IA0188680Medicaid