Healthcare Provider Details

I. General information

NPI: 1255339818
Provider Name (Legal Business Name): WILLIAM N DAWSON JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 09/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 SOUTHRIDGE DR
RENO NV
89509-3253
US

IV. Provider business mailing address

130 SOUTHRIDGE DR
RENO NV
89509-3253
US

V. Phone/Fax

Practice location:
  • Phone: 775-329-4124
  • Fax:
Mailing address:
  • Phone: 775-329-4124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number2992
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: