Individual
KEVIN C DODSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1620 9TH ST, EAST MOLINE, IL 61244-2120
(309) 755-3809
(309) 755-3860
Mailing address
1620 9TH ST, EAST MOLINE, IL 61244-2120
(309) 755-3809
(309) 755-3860
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004304
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060201286
BLUE CROSS AND BLUE SHIEL
IL
05
—
016004304
—
IL
01
—
020110
HEALTH ALLIANCE
IL
01
—
0436154
IME
IA
01
—
326507258
TRICARE
IL
01
—
363660257003
TRICARE
IA
01
—
36473
WELLMARK BLUE CROSS BLUE SHIELD
IA
01
—
480007485
MEDICARE RAILROAD
IL
01
—
I12453
MEDICARE
IA
01
—
IA0102
UNITED HEALTHCARE
IA
01
—
IL0101
UNITED HEALTHCARE
IL
01
—
P00204462
MEDICARE RAILROAD
IA
Enumeration date
07/13/2005
Last updated
10/12/2011
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