Provider Demographics
NPI:1780821108
Name:DIXON, ROSS WILLIAM II (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:WILLIAM
Last Name:DIXON
Suffix:II
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 BLAIR ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648
Mailing Address - Country:US
Mailing Address - Phone:814-932-6962
Mailing Address - Fax:814-695-8241
Practice Address - Street 1:1201 BLAIR ST
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648
Practice Address - Country:US
Practice Address - Phone:814-932-6962
Practice Address - Fax:814-695-8241
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443210183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist