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NPI Code Detail

MEDICARE: DAWSON J WILLIAMS

MEDICARE: DAWSON J WILLIAMS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyF1501002AR

General Provider Information

NPI Number : 1104217611
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAWSON J WILLIAMS
Provider Business Mailing Address
First Line : 112 FAIR OAKS DR
Second Line :
City : JACKSONVILLE
State : AR
Zip : 72076-4280
Country : US
Telephone Number : 501-837-9723
Fax Number :
Provider Business Practice Location Address
First Line : 4700 W COMMERCIAL DR STE B1
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72116-8089
Country : US
Telephone Number : 501-837-9723
Fax Number :
Authorized Official
Title or Position : THERAPIST
Name : DAWSON WILLIAMS
Credential : LAMFT
Telephone Number : 501-837-9723
Provider Enumeration Date : 02/05/2015
Last Update Date : 02/05/2015

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