Individual
JOHN MAC DAWSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1995 E STATE ST, SALEM, OH 44460-2423
(330) 332-1551
Mailing address
2612 W PINE LAKE RD, COLUMBIANA, OH 44408-9770
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34004795D
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0787322
—
OH
01
—
942460636387
CARESOURCE
OH
01
—
P00194519
MEDICARE RR-GA
OH
Enumeration date
05/28/2006
Last updated
07/08/2007
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