Provider Demographics
NPI:1942336797
Name:DAWSON, TIMOTHY FISHER (OD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:FISHER
Last Name:DAWSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7875 MONTGOMERY RD
Mailing Address - Street 2:STE L105
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-4344
Mailing Address - Country:US
Mailing Address - Phone:513-791-6106
Mailing Address - Fax:
Practice Address - Street 1:7875 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-4344
Practice Address - Country:US
Practice Address - Phone:513-791-6106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4185152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist