Provider Demographics
NPI:1316430978
Name:OBRIEN, DAWN (PA-C)
Entity type:Individual
Prefix:MISS
First Name:DAWN
Middle Name:
Last Name:OBRIEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4717 HWY 80 E STE H-1
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-2943
Mailing Address - Country:US
Mailing Address - Phone:912-898-2227
Mailing Address - Fax:912-898-2230
Practice Address - Street 1:4717 HWY 80 E STE H-1
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31410-2943
Practice Address - Country:US
Practice Address - Phone:770-722-0650
Practice Address - Fax:912-898-2230
Is Sole Proprietor?:No
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8801363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant