Provider Demographics
NPI:1356435119
Name:DIXON, REBECCA M (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:M
Last Name:DIXON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:STE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:317-274-1201
Mailing Address - Fax:317-278-9905
Practice Address - Street 1:1701 N SENATE AVE
Practice Address - Street 2:DEPT OF PEDIATRICS
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5306
Practice Address - Country:US
Practice Address - Phone:317-962-8067
Practice Address - Fax:317-962-3796
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2023-11-27
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Provider Licenses
StateLicense IDTaxonomies
IN01057714208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200448420Medicaid
MI4873528Medicaid
IN200448420Medicaid
145590G9Medicare ID - Type Unspecified