Dawson, Fred Jeston
Dawson, Fred Jeston is an individual health care provider with primary practice located at 1055 N 500 W Suite 112, Provo UT 84604-3305. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Dawson, Fred Jeston can be contacted via phone (801) 812-4624.Contact Information
Primary practice address
1055 N 500 W Suite 112
Provo UT 84604-3305
Phone: (801) 812-4624
Fax: (801) 812-4699
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 11013885A | Indiana |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 41926 | Arizona |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 9282119-1205 | Utah |
Profile Details
| NPI number | 1316106131 |
|---|---|
| LBN Legal business name | Dawson, Fred Jeston |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2008 |
| Last updated | Nov 27th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316106131 | NPPES |
| Arizona | MEDICAID | 915540 |
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