Provider Demographics
NPI:1790839793
Name:DAWSON COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:DAWSON COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTFALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-535-5743
Mailing Address - Street 1:PO BOX 245
Mailing Address - Street 2:54 HWY 53 EAST
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-0005
Mailing Address - Country:US
Mailing Address - Phone:706-265-2611
Mailing Address - Fax:706-265-1636
Practice Address - Street 1:54 HWY 53 EAST
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-0005
Practice Address - Country:US
Practice Address - Phone:706-265-2611
Practice Address - Fax:706-265-1636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00051972CMedicaid
GA00058638AMedicaid
GA00456442MMedicaid
GA00442945CMedicaid
GA00479421HMedicaid
GA00479421HMedicaid