Healthcare Provider Details

I. General information

NPI: 1659086486
Provider Name (Legal Business Name): WILLIAM MURRY DODSON CNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: WILLIAM MURRY DODSON CNA

II. Dates (important events)

Enumeration Date: 01/17/2023
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18308 COMMISSION RD STE A
LONG BEACH MS
39560-2402
US

IV. Provider business mailing address

18308 COMMISSION RD STE A
LONG BEACH MS
39560-2402
US

V. Phone/Fax

Practice location:
  • Phone: 228-343-6734
  • Fax:
Mailing address:
  • Phone: 228-343-6734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberCN0014242811
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number31238
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: