Healthcare Provider Details
I. General information
NPI: 1023799004
Provider Name (Legal Business Name): JESSICA LYNN DAWSON MD, MSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/31/2023
Last Update Date: 01/31/2024
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2000 MEMORIAL DRIVE SUITE B
FARRELL PA
16121
US
IV. Provider business mailing address
3600 FORBES AVENUE FORBES TOWER-PLAZA LEVEL SUITE 140
PITTSBURGH PA
15213
US
V. Phone/Fax
- Phone: 724-528-2513
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: