Provider Demographics
NPI:1619126687
Name:DIXON, GRACE ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:ANN
Last Name:DIXON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1340 HAL GREER BLVD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3800
Mailing Address - Country:US
Mailing Address - Phone:304-399-6501
Mailing Address - Fax:304-399-6528
Practice Address - Street 1:1400 HAL GREER BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-4114
Practice Address - Country:US
Practice Address - Phone:304-399-6501
Practice Address - Fax:304-399-6528
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV261022085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology