Provider Demographics
NPI:1467861484
Name:DAWSON, JULIE BREWER
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:BREWER
Last Name:DAWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 BAPTIST DR
Mailing Address - Street 2:SUITE160
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-2026
Mailing Address - Country:US
Mailing Address - Phone:601-790-9820
Mailing Address - Fax:601-790-9822
Practice Address - Street 1:501 BAPTIST DR
Practice Address - Street 2:SUITE160
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-2026
Practice Address - Country:US
Practice Address - Phone:601-790-9820
Practice Address - Fax:601-790-9822
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist