Provider Demographics
NPI:1831233139
Name:DAWSON, PATRICK ALTON (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:ALTON
Last Name:DAWSON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 W ELM AVE
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-6933
Mailing Address - Country:US
Mailing Address - Phone:541-289-7075
Mailing Address - Fax:541-314-4873
Practice Address - Street 1:1122 W ELM AVE
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-6933
Practice Address - Country:US
Practice Address - Phone:541-289-7075
Practice Address - Fax:541-314-4873
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD166627207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1831233139OtherNATIONAL PROVIDER IDENTIFIER
IDM-9863OtherMEDICAL LICENSE
ORMD166627OtherOREGON MEDICAL BOARD
ORMD166627OtherOREGON MEDICAL BOARD
1104153428OtherGROUP NATIONAL PROVIDER IDENTIFIER (GNPI)
1831233139OtherNATIONAL PROVIDER IDENTIFIER
R174901OtherPROVIDER TRANSACTION ACCESS NUMBER (PTAN)
R174901OtherPROVIDER TRANSACTION ACCESS NUMBER (PTAN)