Provider Demographics
NPI:1215664032
Name:DAWSON, GEORGIA GWYNN (DC)
Entity type:Individual
Prefix:DR
First Name:GEORGIA
Middle Name:GWYNN
Last Name:DAWSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 S SAINT LOUIS ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7223
Mailing Address - Country:US
Mailing Address - Phone:870-307-4798
Mailing Address - Fax:
Practice Address - Street 1:1070 S SAINT LOUIS ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7223
Practice Address - Country:US
Practice Address - Phone:870-307-4798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR16344111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor