Provider Demographics
NPI:1194821132
Name:DAWSON, TERRY LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:LEE
Last Name:DAWSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:503 CLARK ST NE
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-1921
Mailing Address - Country:US
Mailing Address - Phone:256-739-0801
Mailing Address - Fax:256-739-0027
Practice Address - Street 1:1800 AL HIGHWAY 157 STE 301
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-1273
Practice Address - Country:US
Practice Address - Phone:256-736-5507
Practice Address - Fax:256-736-5543
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00007354207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL121923Medicaid
AL51002890OtherBLUE CROSS OF ALABAMA
ALE869Medicare PIN
C75148Medicare UPIN
AL529202280Medicaid
AL000002890Medicare PIN