Provider Demographics
NPI:1528396272
Name:HIXON, ELEANOR YVONNE (MD)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:YVONNE
Last Name:HIXON
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 1:5100 WINDSOR MILL RD.
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207
Mailing Address - Country:US
Mailing Address - Phone:410-522-0884
Mailing Address - Fax:410-522-2712
Practice Address - Street 1:4401 EASTERN AVENUE
Practice Address - Street 2:BLDG 45 SUITE 2H
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224
Practice Address - Country:US
Practice Address - Phone:410-522-0884
Practice Address - Fax:410-522-2712
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD334662083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine