Individual
JORDAN RICHARD DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
600 N PICKAWAY ST, CIRCLEVILLE, OH 43113-1447
(614) 566-8333
(614) 566-5189
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.17030
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0118258
—
OH
Enumeration date
01/29/2015
Last updated
03/28/2023
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