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General NPI Number Information
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NPI Number | 1922248558
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Entity Type | Organization
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Legal Business Name | ROBERT L DIXON-GORDON MD LLC
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Dates
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Enumeration Date | 02/22/2009
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Last Update Date | 02/22/2009
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Provider Practice Location Address
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Address Line | 2735 BUFFALO RD STE 3
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City | ROCHESTER
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State | NY
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Zip | 14624-1337
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Country | US
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Telephone | 585-458-2160
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Fax | 585-458-2165
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Provider Business Mailing Address
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Address Line | 2735 BUFFALO RD STE 3
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City | ROCHESTER
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State | NY
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Zip | 14624-1337
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Country | US
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Telephone | 585-458-2160
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Fax | 585-458-2165
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. ROBERT LAWSON DIXON-GORDON
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Credential | MD
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Telephone | 585-458-2160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 149340
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License Number State | NY
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