Provider Demographics
NPI:1942460779
Name:DIXON, THOMAS K (DC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:K
Last Name:DIXON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8801 W MARKHAM ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205
Mailing Address - Country:US
Mailing Address - Phone:501-223-3314
Mailing Address - Fax:501-223-8023
Practice Address - Street 1:1900 MILITARY RD
Practice Address - Street 2:SUITE 1
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-2805
Practice Address - Country:US
Practice Address - Phone:501-315-6390
Practice Address - Fax:501-315-9576
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1670111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR179170718Medicaid