Provider Demographics
NPI:1497019780
Name:DIXON, PETER LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:LAWRENCE
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:PO BOX 442
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-0442
Mailing Address - Country:US
Mailing Address - Phone:443-333-1003
Mailing Address - Fax:443-420-6922
Practice Address - Street 1:5501 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5503
Practice Address - Country:US
Practice Address - Phone:443-333-1003
Practice Address - Fax:443-420-6922
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program