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NPI Code Detail

MEDICARE: AUDRA SUE DOTSON

MEDICARE:   AUDRA SUE DOTSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1629815980
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDRA SUE DOTSON
Provider Business Mailing Address
First Line : 3141 MEDINA AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43224-4222
Country : US
Telephone Number : 614-725-2824
Fax Number : 614-725-2828
Provider Business Practice Location Address
First Line : 3141 MEDINA AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43224-4222
Country : US
Telephone Number : 614-725-2824
Fax Number : 614-725-2828
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2024
Last Update Date : 07/12/2024

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Directions to “ AUDRA SUE DOTSON ” Practice Location

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