Individual
DR. JAMES T DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
919B CHAMBERS BLVD, BARDSTOWN, KY 40004-2526
(502) 349-1411
(502) 349-0980
Mailing address
919B CHAMBERS BLVD, BARDSTOWN, KY 40004-2526
(502) 349-1411
(502) 349-0980
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
02609
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000298318
ANTHEM BC/BS
KY
01
—
1165473
PASSPORT
KY
Enumeration date
06/30/2005
Last updated
09/15/2011
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