Basic Information
Provider Information
NPI: 1487618609
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAWSON
FirstName: JAMES
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 235019
Address2:  
City: MONTGOMERY
State: AL
PostalCode: 361235019
CountryCode: US
TelephoneNumber: 3342791450
FaxNumber: 3342791660
Practice Location
Address1: 1601 WATSON BLVD
Address2:  
City: WARNER ROBINS
State: GA
PostalCode: 310933431
CountryCode: US
TelephoneNumber: 4783290051
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/14/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X37985GAX Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP2900X037985GAX Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

No ID Information.


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