| Doctor Name: | BRIAN JEREMY DIXON |
| NPI Number: | 1588635593 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 20254 |
| Business Practice Address: | 900 Fairmont Rd Westover, WV - 265013847 |
| Business Phone Number: | 3042927316 |
| Business Fax Number: | 3042964408 |
| Mailing Address: | 900 Fairmont Rd, MORGANTOWN |
| State: | WV |
| Postal Code: | 265013847 |
| Phone Number: | 3045999400 |
| Fax Number: | 3045998917 |
| NPI Enumeration Date: | 01/28/2006 |
| NPI Last Update Date: | 02/05/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 193200000X |
| License Number: | 20254 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Group |
| Taxonomy Classification: | Multi-Specialty |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A business group of one or more individual practitioners, who practice with different areas of specialization. |