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Individual
DR. DOUGLAS R DODSON
Active
Individual
DR. DOUGLAS R DODSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
A-101394
NM
207X00000X
Orthopaedic Surgery Physician
A-101394
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000L1222
—
NM
01
—
201002522
PRESBYTERIAN
NM
01
—
NM004006
BLUE CROSS BLUE SHIELD
NM
Enumeration date
02/03/2006
Last updated
04/28/2017
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