Healthcare Provider Details

I. General information

NPI: 1467588160
Provider Name (Legal Business Name): ANGELA M DAWSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 06/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 E PARRISH AVE BLDG B STE 201
OWENSBORO KY
42303-1449
US

IV. Provider business mailing address

2200 E PARRISH AVE BLDG B STE 201
OWENSBORO KY
42303-1449
US

V. Phone/Fax

Practice location:
  • Phone: 270-926-3700
  • Fax: 270-926-2114
Mailing address:
  • Phone: 270-926-3700
  • Fax: 270-926-2114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number41041
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: