MEDICARE: JUDD WALTER DAWSON D.O.

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
1	207Q00000X	Family Medicine Physician	20A10757	CA
2	207Q00000X	Family Medicine Physician	DR-46006	CO
3	207Q00000X	Family Medicine Physician	OS025512	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457431991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDD WALTER DAWSON D.O.

Provider Business Mailing Address
First Line	:	1801 16TH ST
Second Line	:
City	:	GREELEY
State	:	CO
Zip	:	80631-5154
Country	:	US
Telephone Number	:	970-352-4121
Fax Number	:	970-378-4315

Provider Business Practice Location Address
First Line	:	2425 GARDEN WAY STE 102
Second Line	:
City	:	HERMITAGE
State	:	PA
Zip	:	16148-5215
Country	:	US
Telephone Number	:	724-981-1777
Fax Number	:	724-342-2879

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	02/11/2026

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