Individual
DR. BRIAN LESLIE DODDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 N 10TH ST, CANON CITY, CO 81212-3460
(719) 275-3288
(719) 269-7115
Mailing address
1012 W BELLA CASA DR, PUEBLO WEST, CO 81007-3101
(719) 252-2853
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
42745
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000178152
—
CO
01
—
D0669947
ANTHEM BC BS
CO
01
—
P00140151
RAILROAD MEDICARE
—
Enumeration date
11/16/2006
Last updated
01/08/2025
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