Individual
JACK LEVERN DODD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1619 S HIGH AVE, AMES, IA 50010-8055
(515) 232-5811
Mailing address
2004 PINEHURST DR, AMES, IA 50010-4561
(515) 292-4474
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD-17136
IA
Other
Enumeration date
09/15/2005
Last updated
08/07/2019
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