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General NPI Number Information
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NPI Number | 1831383231
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Entity Type | Organization
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Legal Business Name | DAWSON FAMILY MEDICINE, LLC
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 08/29/2007
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Provider Practice Location Address
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Address Line | 130 E MAIN ST
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City | FORSYTH
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State | GA
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Zip | 31029-1946
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Country | US
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Telephone | 478-992-9006
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Fax |
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Provider Business Mailing Address
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Address Line | 3025 BRECKINRIDGE BLVD STE 120
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City | DULUTH
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State | GA
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Zip | 30096-4979
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL A DAWSON
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Credential | MD
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Telephone | 478-992-5795
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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 | 043192
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License Number State | GA
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