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NPI Code Detail

MEDICARE: DR. KEITH R. DIXON M.D.

MEDICARE: DR. KEITH R. 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
1207RP1001XPulmonary Disease Physician25MA07638600NJ
2207RS0012XSleep Medicine (Internal Medicine) Physician25MA07638600NJ

General Provider Information

NPI Number : 1982606810
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEITH R. DIXON M.D.
Provider Business Mailing Address
First Line : 38 MEADOWLANDS PKWY
Second Line : STE 205
City : SECAUCUS
State : NJ
Zip : 07094-2925
Country : US
Telephone Number : 551-257-7015
Fax Number : 551-257-7025
Provider Business Practice Location Address
First Line : 282 WASHINGTON ST
Second Line :
City : HARTFORD
State : CT
Zip : 06106-3322
Country : US
Telephone Number : 860-837-5890
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 04/14/2022

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