MEDICARE: WOODROW DIXON PHARMD

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
1	183500000X	Pharmacist	PD09191	AR

General Provider Information

NPI Number	:	1649615592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WOODROW DIXON PHARMD

Provider Business Mailing Address
First Line	:	4460 RODGERS RD E
Second Line	:
City	:	RISON
State	:	AR
Zip	:	71665-9139
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	908 W 4TH ST
Second Line	:
City	:	FORDYCE
State	:	AR
Zip	:	71742-2216
Country	:	US
Telephone Number	:	870-352-2161
Fax Number	:	870-352-3236

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2013
Last Update Date	:	05/06/2013

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Directions to “ WOODROW DIXON PHARMD” Practice Location

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