Provider Demographics
NPI:1669418216
Name:DIXON-SCOTT, BARBARA A (MD, PHD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:DIXON-SCOTT
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:A
Other - Last Name:DIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:965 MATTOX DR
Mailing Address - Street 2:
Mailing Address - City:SULLIVAN
Mailing Address - State:MO
Mailing Address - Zip Code:63080-2365
Mailing Address - Country:US
Mailing Address - Phone:573-860-8000
Mailing Address - Fax:
Practice Address - Street 1:965 MATTOX DR
Practice Address - Street 2:
Practice Address - City:SULLIVAN
Practice Address - State:MO
Practice Address - Zip Code:63080-2365
Practice Address - Country:US
Practice Address - Phone:573-860-6000
Practice Address - Fax:573-860-6016
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO105362207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
100015664OtherRAILROAD MEDICARE
MO208956722Medicaid
G51492Medicare UPIN
MO208956722Medicaid
028012943Medicare ID - Type Unspecified