Provider Demographics
NPI:1881188431
Name:DAWSON, COURTNEY DAVIS (MD)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:DAVIS
Last Name:DAWSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 POCKET RD
Mailing Address - Street 2:
Mailing Address - City:HURT
Mailing Address - State:VA
Mailing Address - Zip Code:24563
Mailing Address - Country:US
Mailing Address - Phone:434-656-1274
Mailing Address - Fax:
Practice Address - Street 1:527 POCKET RD
Practice Address - Street 2:
Practice Address - City:HURT
Practice Address - State:VA
Practice Address - Zip Code:24563
Practice Address - Country:US
Practice Address - Phone:434-324-9150
Practice Address - Fax:434-324-8248
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-18
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI0116031807390200000X
VA0101271546207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1881188431Medicaid