Tedd E Dawson MD Inc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

C38007 Issued in CA

Legal business name

TEDD E DAWSON MD INC

Practice address

1196 S Main St
Willits, CA 95490-4304

Phone

(707) 459-3070

Fax

(707) 459-3052

NPI assigned

Jun 12, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tedd Eugene Dawson, M.D.

Title

President

Phone

(707) 459-3070

Specialties & licenses 2

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235520000000",
    "number": "1730349739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1196 S MAIN ST",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954904304",
            "telephone_number": "707-459-3070",
            "fax_number": "707-459-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1196 S MAIN ST",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954904304",
            "telephone_number": "707-459-3070",
            "fax_number": "707-459-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEDD E DAWSON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-12",
        "last_updated": "2009-02-25",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "TEDD",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-459-3070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "C38007",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "C38007",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457330680",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C380070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Willits, CA
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• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.