Healthcare Provider Details

I. General information

NPI: 1386630556
Provider Name (Legal Business Name): GEORGE B DAWSON MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 10/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8121 NATIONAL AVE STE 108
MIDWEST CITY OK
73110-7530
US

IV. Provider business mailing address

PO BOX 272495
OKLAHOMA CITY OK
73137-2495
US

V. Phone/Fax

Practice location:
  • Phone: 405-775-9350
  • Fax: 405-775-9360
Mailing address:
  • Phone: 405-775-9350
  • Fax: 405-775-9360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number18162
License Number StateOK

VIII. Authorized Official

Name: CATHY PRICE
Title or Position: BILLING MANAGER
Credential:
Phone: 405-775-9350