Basic Information
| Provider Information | |||||||||
| NPI: | 1104320209 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | DAWSON | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | BRIAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 47 NEW SCOTLAND AVENUE, DEPT. OF ANESTHESIOLOGY | ||||||||
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| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5182624302 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1600 SW ARCHER RD | ||||||||
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| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326103003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522650077 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2018 | ||||||||
| LastUpdateDate: | 06/02/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 154615 | FL | N | Allopathic & Osteopathic Physicians | Anesthesiology | 390200000X | 154615 | FL | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 390200000X | 64008 | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.