Provider Demographics
NPI:1790729895
Name:DIXSON, JAMES DON (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DON
Last Name:DIXSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JIMMY
Other - Middle Name:DON
Other - Last Name:DIXSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8900 SILVER HILL DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-3316
Mailing Address - Country:US
Mailing Address - Phone:405-557-1200
Mailing Address - Fax:405-557-1977
Practice Address - Street 1:4300 W MEMORIAL RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8304
Practice Address - Country:US
Practice Address - Phone:405-936-5800
Practice Address - Fax:405-936-5810
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9473208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100128630AMedicaid
OK112120588OtherRAILROAD
OK9473OtherLICENSE
OK15695OtherOBNDD
E10993Medicare UPIN
OK100128630AMedicaid