Physician Compare National (NPI:1205835568)

HEALTHCARE PROVIDER: GEORGE STEPHEN DAWSON II M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1205835568
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4688719743
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20191216000483
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DAWSON
	Individual professional last name
Provider First Name	GEORGE
	Individual professional first name
Provider Middle Name	STEPHEN
	Individual professional middle name
Provider Name Suffix Text	II
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	JC EDWARDS SCHOOL OF MEDICINE, MARSHALL UNIVERSITY
	Individual professional's medical school
Graduation Year	1997
	Individual professional's medical school graduation year
Primary Specialty	OTOLARYNGOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ULTIMATE HEALTH SERVICES INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8921912536
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	80
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	5897 COUNTY RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 107
	Group Practice or individual's line 2 address
City	PROCTORVILLE
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	456698852
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7408869911
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	510007
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST MARY'S MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y