Healthcare Provider Details

I. General information

NPI: 1972557247
Provider Name (Legal Business Name): DOYNE DODD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 01/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 LILE DR, SUITE 1100
LITTLE ROCK AR
72205-6333
US

IV. Provider business mailing address

9601 LILE DRIVE, SUITE 1100
LITTLE ROCK AR
72205-6333
US

V. Phone/Fax

Practice location:
  • Phone: 501-227-5256
  • Fax: 501-227-9151
Mailing address:
  • Phone: 501-227-5256
  • Fax: 501-227-9151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberC-2970
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: