Provider Demographics
NPI:1730174244
Name:DIXON, ARTHUR (MD)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:
Last Name:DIXON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9090 FRANKLIN HILL ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-9103
Mailing Address - Country:US
Mailing Address - Phone:570-223-5010
Mailing Address - Fax:570-223-5015
Practice Address - Street 1:9090 FRANKLIN HILL ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-9103
Practice Address - Country:US
Practice Address - Phone:570-223-5010
Practice Address - Fax:570-223-5015
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD043443L2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0013927470001Medicaid
PA0013927470001Medicaid
PA029942Medicare ID - Type Unspecified