Provider Demographics
NPI:1407141492
Name:DAWSON, PETER ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:ANTHONY
Last Name:DAWSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 N RIVERSIDE RD STE 130
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-2508
Mailing Address - Country:US
Mailing Address - Phone:816-271-7673
Mailing Address - Fax:816-271-4924
Practice Address - Street 1:802 N RIVERSIDE RD STE 130
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-2508
Practice Address - Country:US
Practice Address - Phone:816-271-7673
Practice Address - Fax:816-271-4924
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011014907208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation