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General NPI Number Information
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NPI Number | 1801832373
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Entity Type | Individual
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Provider Name | DAWN A FAIRLEY DO
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Gender | Female
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 04/27/2012
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Provider Practice Location Address
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Address Line | 103 S 18TH ST
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City | UNIONVILLE
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State | MO
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Zip | 63565-1642
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Country | US
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Telephone | 660-947-2300
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Fax | 660-947-2307
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Provider Business Mailing Address
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Address Line | 103 S 18TH ST
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City | UNIONVILLE
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State | MO
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Zip | 63565-1642
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Country | US
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Telephone | 660-947-2300
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Fax | 660-947-2307
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS012469
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2006023529
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A 7187
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS 9881
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License Number State | FL
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