Provider Demographics
NPI:1821186669
Name:HIXSON, FREDERICK PETER (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:PETER
Last Name:HIXSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1001 W FAYETTE ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-2859
Mailing Address - Country:US
Mailing Address - Phone:315-472-1488
Mailing Address - Fax:315-472-8060
Practice Address - Street 1:725 IRVING AVE
Practice Address - Street 2:SUITE 314
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1603
Practice Address - Country:US
Practice Address - Phone:315-424-0151
Practice Address - Fax:315-476-0967
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2010-08-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY144531208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1306OtherASPRS
NY1306OtherASPRS
NY39935BMedicare PIN
NYRB7399Medicare PIN
NY240006406Medicare PIN