Provider Demographics
NPI:1427262591
Name:DIXON, WILLIAM N (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:N
Last Name:DIXON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 ASTON AVE
Mailing Address - Street 2:
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39648-2825
Mailing Address - Country:US
Mailing Address - Phone:601-684-2481
Mailing Address - Fax:601-684-2488
Practice Address - Street 1:1311 ASTON AVE
Practice Address - Street 2:
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-2825
Practice Address - Country:US
Practice Address - Phone:601-684-2481
Practice Address - Fax:601-684-2488
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS14639208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS5933484OtherAETNA
LA1695751Medicaid
020038952OtherRAILROAD MEDICARE
MS1730025OtherUNITED HEALTHCARE
MS0055313OtherMISSISSIPPI SELECT
MS00117256Medicaid
020038952OtherRAILROAD MEDICARE
MS090622691Medicare PIN