Healthcare Provider Details

I. General information

NPI: 1184797086
Provider Name (Legal Business Name): DAWN JONINE DOZHIER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 SHEEP SPRINGS WAY
JEMEZ PUEBLO NM
87120
US

IV. Provider business mailing address

5308 HAYES DR NW
ALBUQUERQUE NM
87120-2291
US

V. Phone/Fax

Practice location:
  • Phone: 505-834-7413
  • Fax:
Mailing address:
  • Phone: 505-899-8006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA2006-0048
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: