Russell Louis Dixon, PSYD is a
Clinical Neuropsychologist based in Poplar Bluff, Missouri. Russell Louis Dixon is licensed to practice in Arkansas (license number 90-09P) and his current practice location is
1500 N Westwood Blvd, Poplar Bluff, Missouri. He can be reached at his office (for appointments etc.) via phone at
(573) 686-4151.
NPI number for Russell Louis Dixon is 1144503962 and his current mailing address is 1500 N Westwood Blvd, Poplar Bluff, Missouri. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1144503962.
Healthcare Provider's Profile
| Full Name | Russell Louis Dixon |
|---|
| Gender | Male |
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| Speciality | Clinical Neuropsychologist |
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| Location | 1500 N Westwood Blvd, Poplar Bluff, Missouri |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1144503962
- Provider Enumeration Date: 09/28/2011
- Last Update Date: 08/15/2013
Medical Identifiers
Medical identifiers for Russell Louis Dixon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1144503962 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | 90-09P (Arkansas) | Secondary |
| 103G00000X | Clinical Neuropsychologist | 90-09P (Arkansas) | Primary |
| 103TC0700X | Psychologist - Clinical | 90-09P (Arkansas) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Russell Louis Dixon is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Russell Louis Dixon, PSYD
1500 N Westwood Blvd,
Poplar Bluff, MO 63901-3318
Ph: (573) 686-4151 | Russell Louis Dixon, PSYD
1500 N Westwood Blvd,
Poplar Bluff, MO 63901-3318
Ph: (573) 686-4151 |
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