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NPI Code Detail

MEDICARE: CAREY LEE DODDS M.D.

MEDICARE: CAREY LEE DODDS M.D.
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
1208000000XPediatrics Physician33957KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922069210
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAREY LEE DODDS M.D.
Provider Business Mailing Address
First Line : 2700 STANLEY GAULT PKWY
Second Line : STE 129
City : LOUISVILLE
State : KY
Zip : 40223-5176
Country : US
Telephone Number : 270-326-3949
Fax Number : 270-326-3954
Provider Business Practice Location Address
First Line : 200 CLINIC DR
Second Line :
City : MADISONVILLE
State : KY
Zip : 42431-1661
Country : US
Telephone Number : 270-825-7328
Fax Number : 270-825-6666
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2006
Last Update Date : 12/03/2020

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