Individual
DR. KENNETH LEONARD TODD III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., FACPH, RPVI
Contact information
Practice address
3280 ROSS CLARK CIR, DOTHAN, AL 36303-3040
(334) 678-9494
(334) 678-8878
Mailing address
3280 ROSS CLARK CIR, DOTHAN, AL 36303-3040
(334) 678-9494
(334) 678-8878
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
15348
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-01952
UNITED HEALTHCARE ID#
AL
01
—
51077969
BLUECROSS BLUESHIELD ID#
AL
Enumeration date
12/22/2005
Last updated
02/15/2012
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