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General NPI Number Information
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NPI Number | 1114940137
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Entity Type | Individual
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Provider Name | ERIKA LYNN HIXON RD
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Gender | Female
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 MEDICAL PARK DR
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City | BENTON
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State | AR
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Zip | 72015-3353
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Country | US
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Telephone | 501-776-6000
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Fax | 501-776-6278
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Provider Business Mailing Address
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Address Line | 1118 BROWN SPRINGS LOOP
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City | DONALDSON
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State | AR
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Zip | 71941-9670
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Country | US
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Telephone | 501-384-2636
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 811
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License Number State | AR
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