Provider Demographics
NPI:1568478469
Name:DIXON, WILLIAM COY (PA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:COY
Last Name:DIXON
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 28949
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-8949
Mailing Address - Country:US
Mailing Address - Phone:559-228-5400
Mailing Address - Fax:559-224-3920
Practice Address - Street 1:560 E HERNDON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2822
Practice Address - Country:US
Practice Address - Phone:559-437-7304
Practice Address - Fax:559-437-7308
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA13665363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA13665OtherLICENSE #