Provider Demographics
NPI:1689868416
Name:DIXON, MEGAN BETH (MD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:BETH
Last Name:DIXON
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Gender:F
Credentials:MD
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Mailing Address - Street 1:6622 N 91ST AVE
Mailing Address - Street 2:STE 220
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305-2569
Mailing Address - Country:US
Mailing Address - Phone:602-759-6883
Mailing Address - Fax:602-224-3358
Practice Address - Street 1:5040 N 15TH AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015
Practice Address - Country:US
Practice Address - Phone:602-200-9711
Practice Address - Fax:602-200-9712
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2018-06-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ40556207RN0300X
MN54802207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ351533Medicaid
AZ86-0959487OtherTAX-ID