Frederickson, Dawn D.
Frederickson, Dawn D. is an individual health care provider with primary practice located at 7232 Engle Rd , Fort Wayne IN 46804-2222. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Frederickson, Dawn D. can be contacted via phone (260) 436-7205.Contact Information
Primary practice address
7232 Engle Rd
Fort Wayne IN 46804-2222
Phone: (260) 436-7205
Fax: (260) 432-1339
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 18002667A | Indiana |
Profile Details
| NPI number | 1760489009 |
|---|---|
| LBN Legal business name | Frederickson, Dawn D. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 1st, 2005 |
| Last updated | Jun 20th, 2016 - about 10 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 | 1760489009 | NPPES |
| Indiana | MEDICAID | 200043560 |
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