Provider Demographics
NPI:1720637309
Name:DIXON, ADAM
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:DIXON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13021 S 48TH ST APT 1030
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-4151
Mailing Address - Country:US
Mailing Address - Phone:480-560-6370
Mailing Address - Fax:
Practice Address - Street 1:13021 S 48TH ST APT 1030
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-4151
Practice Address - Country:US
Practice Address - Phone:480-560-6370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information