Individual
EDWARD A. DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 271-6122
(816) 271-6019
Mailing address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 271-6122
(816) 271-6019
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
T-02280
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200577260A
—
KS
Enumeration date
09/03/2008
Last updated
03/17/2018
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