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Individual

DR. RENEE L DODGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
289 IRELAND AVE, BLDG 851 VA CLINIC, FORT KNOX, KY 40121-5111
(502) 624-0235
Mailing address
289 IRELAND AVE, BLDG 851 VA CLINIC, FORT KNOX, KY 40121-5111
(502) 624-0235

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
KY02722
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64053192
KY
Enumeration date
09/27/2005
Last updated
11/07/2012
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