Provider Demographics
NPI:1669435319
Name:DIXON, TIMOTHY BURT (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:BURT
Last Name:DIXON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6567 E CARONDELET DR
Mailing Address - Street 2:SUITE 415
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2156
Mailing Address - Country:US
Mailing Address - Phone:520-885-6701
Mailing Address - Fax:520-885-9037
Practice Address - Street 1:6567 E CARONDELET DR
Practice Address - Street 2:SUITE 415
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2156
Practice Address - Country:US
Practice Address - Phone:520-885-6701
Practice Address - Fax:520-885-9037
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ33731207XS0106X, 207XS0114X, 207XX0004X, 207XX0005X, 207XX0801X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ932394Medicaid
AZ20-3604285OtherTIN
AZZ121615Medicare PIN
AZ20-3604285OtherTIN