Provider Demographics
NPI:1184767204
Name:DAWSON, JOAN F (DO)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:F
Last Name:DAWSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 FRANCE AVE SO
Mailing Address - Street 2:SUITE 405
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4544
Mailing Address - Country:US
Mailing Address - Phone:952-806-9000
Mailing Address - Fax:952-806-9001
Practice Address - Street 1:7300 FRANCE AVE SO
Practice Address - Street 2:SUITE 405
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4544
Practice Address - Country:US
Practice Address - Phone:952-806-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN36788207VG0400X
MNMN36788204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Not Answered204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
G39595Medicare UPIN