Provider Demographics
NPI:1508169392
Name:DIXSON, DOROTHY RENA
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:RENA
Last Name:DIXSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DOROTHY
Other - Middle Name:RENA
Other - Last Name:TOWNS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:37501 JOY ROAD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185
Mailing Address - Country:US
Mailing Address - Phone:734-451-1155
Mailing Address - Fax:734-451-0177
Practice Address - Street 1:37501 JOY RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-7538
Practice Address - Country:US
Practice Address - Phone:734-451-1155
Practice Address - Fax:734-451-0177
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501011084208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation