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NPI Code Detail

MEDICARE: RICHARD BEACH DAWSON M.D.

MEDICARE: RICHARD BEACH DAWSON M.D.
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
1207Y00000XOtolaryngology Physician9910OK

General Provider Information

NPI Number : 1508964289
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD BEACH DAWSON M.D.
Provider Business Mailing Address
First Line : 4805 S WESTERN AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73109-3835
Country : US
Telephone Number : 405-636-1506
Fax Number :
Provider Business Practice Location Address
First Line : 4805 S WESTERN AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73109-3835
Country : US
Telephone Number : 405-636-1506
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 07/08/2007

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