Jerry W. Dixon, M.D., P.a.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

E0176 Issued in AR

Legal business name

JERRY W. DIXON, M.D., P.A.

Practice address

3 Medical Park Dr
Suite 201
Benton, AR 72015-3728

Phone

(501) 778-3361

Fax

(501) 778-3135

NPI assigned

Mar 15, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jerry W. Dixon, M.D.

Title

Owner

Phone

(501) 778-3361

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319760000000",
    "number": "1871627737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MEDICAL PARK DR",
            "address_2": "SUITE 201",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153728",
            "telephone_number": "501-778-3361",
            "fax_number": "501-778-3135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MEDICAL PARK DR",
            "address_2": "SUITE 201",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153728",
            "telephone_number": "501-778-3361",
            "fax_number": "501-778-3135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY W. DIXON, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2011-10-28",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-778-3361",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "AR",
            "license": "E0176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125732001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley E Jendrejas
• Latasha Jenkins, RN
• Morgan Lee Jenkins I
• Janna Lyn Jennings, M.D.
• Sarah Ann Jennings, LPN
• Lucille Jerry, RECOVERY ASSISTANT
• Autumn N Jessen, COTA
• JLM Ventures, Inc.
• JLM Ventures, Inc.
• JM Psychiatry PLLC

• Surgery Physician in Benton, AR
• Providers in Benton, AR by specialty
• Surgery Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.