Provider Demographics
NPI:1366588857
Name:DAWSON, DAVID GENE (DC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:GENE
Last Name:DAWSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 11028
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85230-1028
Mailing Address - Country:US
Mailing Address - Phone:520-836-5921
Mailing Address - Fax:520-836-5159
Practice Address - Street 1:404 E 6TH ST
Practice Address - Street 2:# C
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85222-4158
Practice Address - Country:US
Practice Address - Phone:520-836-5921
Practice Address - Fax:520-836-5159
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ763111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0944730OtherBLUE CROSS BLUE SHIELD