MEDICARE: ANDREW ALEXANDER DIXON M.D.

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	207RN0300X	Nephrology Physician	28761	GA
2	207RN0300X	Nephrology Physician	028761	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110070948	OTHER	GA	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841296514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW ALEXANDER DIXON M.D.

Provider Business Mailing Address
First Line	:	5255 SNAPFINGER PARK DR
Second Line	:	STE 110
City	:	DECATUR
State	:	GA
Zip	:	30035-4066
Country	:	US
Telephone Number	:	770-981-2211
Fax Number	:	770-981-0208

Provider Business Practice Location Address
First Line	:	5255 SNAPFINGER PARK DR
Second Line	:	STE 110
City	:	DECATUR
State	:	GA
Zip	:	30035-4066
Country	:	US
Telephone Number	:	770-981-2211
Fax Number	:	770-981-0208

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

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	03/11/2020

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