Provider Demographics
NPI:1295995512
Name:DIXON, DENNIS K (MD)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:K
Last Name:DIXON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1997 LAURELWOOD LN
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-2918
Mailing Address - Country:US
Mailing Address - Phone:727-480-2840
Mailing Address - Fax:
Practice Address - Street 1:611 S FORT HARRISON AVE
Practice Address - Street 2:#354
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-5301
Practice Address - Country:US
Practice Address - Phone:727-298-6612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108864207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine