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General NPI Number Information
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NPI Number | 1134153711
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Entity Type | Individual
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Provider Name | MICHAEL J DAWSON JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 4 LIVE OAK CT
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City | MOULTRIE
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State | GA
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Zip | 31768-6783
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Country | US
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Telephone | 229-785-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 S GRANGE AVE STE 510
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City | SIOUX FALLS
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State | SD
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Zip | 57105-0401
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Country | US
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Telephone | 605-328-8500
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Fax | 605-328-8501
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 034811
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 9640
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License Number State | SD
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