Provider Demographics
NPI:1770879710
Name:KIRKWOOD, DAWN LYNNE (MD)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:LYNNE
Last Name:KIRKWOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4199 GATEWAY BLVD
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-8940
Mailing Address - Country:US
Mailing Address - Phone:812-858-4610
Mailing Address - Fax:812-858-4611
Practice Address - Street 1:4199 GATEWAY BLVD
Practice Address - Street 2:SUITE 2300
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8940
Practice Address - Country:US
Practice Address - Phone:812-858-4610
Practice Address - Fax:812-858-4611
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.059181207VX0000X
IN01074943A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201308160Medicaid
IN201308160Medicaid