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NPI Code Detail

MEDICARE: DR. BRADLEY P. DIXON MD

MEDICARE: DR. BRADLEY P. DIXON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080P0210XPediatric Nephrology PhysicianOH35.078780OH
22080P0210XPediatric Nephrology PhysicianDR.058918CO

General Provider Information

NPI Number : 1083657068
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRADLEY P. DIXON MD
Provider Business Mailing Address
First Line : PO BOX 110429
Second Line :
City : AURORA
State : CO
Zip : 80042-0429
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13123 E 16TH AVE
Second Line :
City : AURORA
State : CO
Zip : 80045-7106
Country : US
Telephone Number : 720-777-1234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2006
Last Update Date : 11/19/2019

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Directions to “ DR. BRADLEY P. DIXON MD” Practice Location

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