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General NPI Number Information
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NPI Number | 1003082561
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Entity Type | Organization
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Legal Business Name | THOMAS W DAWSON OD
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Dates
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Enumeration Date | 05/05/2008
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Last Update Date | 05/05/2008
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Provider Practice Location Address
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Address Line | 1124 N SUNCOAST BLVD
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-5474
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Country | US
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Telephone | 352-795-3317
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Fax | 352-795-3011
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Provider Business Mailing Address
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Address Line | PO BOX 730
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City | CRYSTAL RIVER
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State | FL
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Zip | 34423-0730
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Country | US
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Telephone | 352-795-3317
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Fax | 352-795-3317
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Authorized Official
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Title or Position | OFFICE MGR
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Name | MRS. MARY F DAWSON
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Credential |
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Telephone | 352-795-3317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | OPC977
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License Number State | FL
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