Provider Demographics
NPI:1104261262
Name:DAWSON, ADAM GREGORY (DO)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:GREGORY
Last Name:DAWSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:3269 STOCKTON HILL RD
Mailing Address - Street 2:PHYSICIAN RESIDENCY OFFICE
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-3619
Mailing Address - Country:US
Mailing Address - Phone:928-757-0649
Mailing Address - Fax:928-681-8638
Practice Address - Street 1:3269 STOCKTON HILL RD
Practice Address - Street 2:PHYSICIAN RESIDENCY OFFICE
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409-3619
Practice Address - Country:US
Practice Address - Phone:928-757-0649
Practice Address - Fax:928-681-8638
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
AZ006725207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program