Individual
DALE DAWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
708 W FOREST AVE, JACKSON, TN 38301-3901
(731) 660-8759
Mailing address
1804 HIGHWAY 45 BYP, SUITE 604, JACKSON, TN 38305-4436
(731) 660-8759
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA511
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970018362
RR MEDICARE
—
Enumeration date
01/13/2006
Last updated
07/16/2009
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