Provider Demographics
NPI:1003900457
Name:ROBISON, DIXON LEE (MD)
Entity type:Individual
Prefix:DR
First Name:DIXON
Middle Name:LEE
Last Name:ROBISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7300 RANCH ROAD 2222, BUILDING 1, STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730
Mailing Address - Country:US
Mailing Address - Phone:512-628-0465
Mailing Address - Fax:512-233-2711
Practice Address - Street 1:24 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-9334
Practice Address - Country:US
Practice Address - Phone:406-723-7272
Practice Address - Fax:406-723-3328
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7576207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT81-0494973OtherFEDERAL TAX ID #
MT105144Medicaid
GA070006921OtherRAILROAD MEDICARE #
MT07511OtherBLUE CROSS BLUE SHIELD #