Healthcare Provider Details

I. General information

NPI: 1841371499
Provider Name (Legal Business Name): GARY N DAWSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 12/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 13TH ST SUITE A
COLUMBUS GA
31906-2596
US

IV. Provider business mailing address

2300 13TH STREET SUITE A
COLUMBUS GA
31906
US

V. Phone/Fax

Practice location:
  • Phone: 706-243-7010
  • Fax: 706-243-7019
Mailing address:
  • Phone: 706-243-7010
  • Fax: 706-243-7019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number053857
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: