Organization
KEVIN C DODSON
Active
Parent organization
KEVIN C DODSON
Organization subpart
Yes
Provider details
NPI number
Legal business name
KEVIN C DODSON
Authorized official
KEVIN C DODSON DPM (OWNER)
(309) 755-3809
Entity
Organization
Contact information
Practice address
1620 9TH ST, EAST MOLINE, IL 61244-2120
(309) 755-3809
(308) 755-3860
Mailing address
1620 9TH ST, P O BOX 664, EAST MOLINE, IL 61244-2120
(309) 755-3809
(308) 755-3860
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
016004304
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060201286
BLUE CROSS BLUE SHIELD
IL
01
—
020110
HEALTH ALLIANCE
IL
01
—
0436154
IME
IA
01
—
326507258
TRICARE
IL
01
—
36473
WELLMARK BLUE CROSS/BLUE SHIELD
IA
01
—
480007485
MEDICARE RAILROAD
IL
01
—
I12453
MEDICARE
IA
01
—
IA0102
UNITED HEALTH CARE
IA
01
—
IL0101
UNITED HEALTHCARE
IL
01
—
P00204462
MEDICARE RAILROAD
IA
Enumeration date
12/28/2007
Last updated
09/16/2011
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