Provider Demographics
NPI:1700016169
Name:DAWSON, JOHN T JR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:T
Last Name:DAWSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:TRAVERS
Other - Last Name:DAWSON
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:18958 COASTAL HWY
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-6196
Mailing Address - Country:US
Mailing Address - Phone:302-645-7672
Mailing Address - Fax:302-645-7842
Practice Address - Street 1:18958 COASTAL HWY
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-6196
Practice Address - Country:US
Practice Address - Phone:302-645-7672
Practice Address - Fax:302-645-7842
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-20
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0009116207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease