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
Fax: (260) 432-1339
Website:

Health care specialties

SpecialtyCodeLicense #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 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760489009 NPPES
Indiana MEDICAID 200043560

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