Healthcare Provider Details

I. General information

NPI: 1104320209
Provider Name (Legal Business Name): JOHN BRIAN DAWSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2018
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

47 NEW SCOTLAND AVENUE, DEPT. OF ANESTHESIOLOGY
ALBANY NY
12208
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0077
  • Fax:
Mailing address:
  • Phone: 518-262-4302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME154615
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberME154615
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: