Healthcare Provider Details

I. General information

NPI: 1548259310
Provider Name (Legal Business Name): RANK O DAWSON JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4767 NORTH BEND RD.
CINCINNATI OH
45211
US

IV. Provider business mailing address

4767 NORTH BEND RD.
CINCINNATI OH
45211
US

V. Phone/Fax

Practice location:
  • Phone: 513-662-3500
  • Fax: 513-389-4751
Mailing address:
  • Phone: 513-662-3500
  • Fax: 513-389-4751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number35047874
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number35 047874
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number35047874
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: