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NPI Code Detail

MEDICARE: SHIRLEY J. DAWSON M.D.

MEDICARE: SHIRLEY J. 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
12084P0800XPsychiatry Physician32276-020WI

General Provider Information

NPI Number : 1558301580
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIRLEY J. DAWSON M.D.
Provider Business Mailing Address
First Line : 571 COUNTY ROAD A
Second Line : PO BOX 588
City : GREEN LAKE
State : WI
Zip : 54941-8630
Country : US
Telephone Number : 920-294-4070
Fax Number :
Provider Business Practice Location Address
First Line : 571 COUNTY ROAD A
Second Line :
City : GREEN LAKE
State : WI
Zip : 54941-8630
Country : US
Telephone Number : 920-294-4070
Fax Number : 920-294-4139
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2006
Last Update Date : 03/09/2017

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Directions to “ SHIRLEY J. DAWSON M.D.” Practice Location

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