Provider Demographics
NPI:1851765820
Name:DIXON, MEGHAN CANTLON (RD)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:CANTLON
Last Name:DIXON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11321 INTERSTATE 30
Mailing Address - Street 2:STE 100
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72209-7040
Mailing Address - Country:US
Mailing Address - Phone:830-265-8004
Mailing Address - Fax:
Practice Address - Street 1:11321 INTERSTATE 30
Practice Address - Street 2:STE 100
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-7040
Practice Address - Country:US
Practice Address - Phone:501-407-2036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1407133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered