Healthcare Provider Details

I. General information

NPI: 1215856067
Provider Name (Legal Business Name): JARROD DAVID DOTSON OTR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3310 TATES CREEK RD
LEXINGTON KY
40502-3487
US

IV. Provider business mailing address

141 S HILL RD
VERSAILLES KY
40383-1394
US

V. Phone/Fax

Practice location:
  • Phone: 859-266-2129
  • Fax:
Mailing address:
  • Phone: 859-492-8169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number166833
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: