Individual
DR. KENNETH BRENTON DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1950 DOWNS BLVD STE 102, FRANKLIN, TN 37064-1562
(615) 435-7780
Mailing address
4323 CAROTHERS PKWY STE 505, FRANKLIN, TN 37067-5920
(615) 435-7780
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD0000017056
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0140590
UHC
—
05
—
3021233
—
TN
01
—
3132242
BLUE CROSS BLUE SHIELD
TN
01
—
4295507
AETNA
—
01
—
8822511
CIGNA
—
Enumeration date
06/08/2005
Last updated
03/14/2024
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