| Jerome A. Dixon, D.o., P.s.c. | |
|
150 W Bear Track Rd Campbellsville KY 42718-8709 | |
| (270) 465-8133 | |
| (270) 789-1543 |
| Full Name | Jerome A. Dixon, D.o., P.s.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 150 W Bear Track Rd, Campbellsville, Kentucky |
| Authorized Official Name and Position | Jerome A. Dixon (PRESIDENT) |
| Authorized Official Contact | 2704658133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jerome A. Dixon, D.o., P.s.c. 150 W Bear Track Rd Campbellsville KY 42718-8709 Ph: (270) 465-8133 | Jerome A. Dixon, D.o., P.s.c. 150 W Bear Track Rd Campbellsville KY 42718-8709 Ph: (270) 465-8133 |
| NPI Number | 1508932955 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 09/19/2014 |
| Medicare PECOS PAC ID | 8426017229 |
|---|---|
| Medicare Enrollment ID | O20041007000436 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508932955 | NPI | - | NPPES |
| 64023203 | Medicaid | KY |
| Provider Name | Troy M Nelson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730110206 PECOS PAC ID: 2365341781 Enrollment ID: I20040106000000 |
| Provider Name | Milton Jackson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437198546 PECOS PAC ID: 9739071523 Enrollment ID: I20040326000574 |
| Provider Name | Jerome A Dixon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215919451 PECOS PAC ID: 5799744363 Enrollment ID: I20041008000353 |
| Provider Name | Kevin A Graves |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164765582 PECOS PAC ID: 2668601824 Enrollment ID: I20140210001625 |
| Provider Name | Lori Ann Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235695677 PECOS PAC ID: 5193068005 Enrollment ID: I20190516001617 |
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