Individual
JACK DAWSON
Active
Individual
JACK DAWSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0102207240
VA
207X00000X
Orthopaedic Surgery Physician
Primary
34.015892
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0230609
—
OH
Enumeration date
02/08/2017
Last updated
09/19/2023
Update your record
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