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Individual

MRS. JO ANN DODD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
667 THOMPSON ST, HOMER, GA 30547-3110
(706) 677-2296
(706) 677-4042
Mailing address
154 BARRETT RD, ALTO, GA 30510-2403
(770) 869-7336

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN129380
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00051972B
GA
05
00058638A
GA
05
00442945B
GA
05
00456442N
GA
05
00479751E
GA
01
10044114
AMERIGROUP
GA
01
338783
WELLCARE
GA
Enumeration date
10/05/2006
Last updated
07/09/2007
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