Healthcare Provider Details

I. General information

NPI: 1619126687
Provider Name (Legal Business Name): GRACE ANN DIXON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2008
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 23RD ST
ASHLAND KY
41101-2832
US

IV. Provider business mailing address

1340 HAL GREER BLVD
HUNTINGTON WV
25701-3804
US

V. Phone/Fax

Practice location:
  • Phone: 606-329-0060
  • Fax: 606-325-9366
Mailing address:
  • Phone: 304-399-6501
  • Fax: 304-399-6528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number26102
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberTP793
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: