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NPI Code Detail

MEDICARE: PATRICK R DAWSON OD

MEDICARE: PATRICK R DAWSON OD
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
1152W00000XOptometrist4831OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2260887OTHEROHAETNA
3000000338072OTHEROHANTHEM
4200806361029OTHEROHCARESOURCE
52201865OTHEROHUNITED HEALTH CARE

General Provider Information

NPI Number : 1437153814
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK R DAWSON OD
Provider Business Mailing Address
First Line : 1385 WILLOW CHASE DR
Second Line :
City : SPRINGFIELD
State : OH
Zip : 45503-7720
Country : US
Telephone Number : 937-399-2519
Fax Number : 937-399-2346
Provider Business Practice Location Address
First Line : 1674 N LIMESTONE ST
Second Line :
City : SPRINGFIELD
State : OH
Zip : 45503-2652
Country : US
Telephone Number : 937-399-4101
Fax Number : 937-399-2346
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 07/09/2007

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