Basic Information
Provider Information
NPI: 1043794670
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAWKINS
FirstName: MEGAN
MiddleName: ELIZABETH
NamePrefix: MS.
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5959 S SHERWOOD FOREST BLVD
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 708166038
CountryCode: US
TelephoneNumber: 2257653456
FaxNumber: 2257659196
Practice Location
Address1: 7777 HENNESSY BLVD STE 501B
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 708084300
CountryCode: US
TelephoneNumber: 2257653456
FaxNumber: 2257432346
Other Information
ProviderEnumerationDate: 09/19/2018
LastUpdateDate: 02/07/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/07/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X310466LAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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