Healthcare Provider Details

I. General information

NPI: 1609055664
Provider Name (Legal Business Name): DR. ANDREW M. DODD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2007
Last Update Date: 03/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2282 NEWTON ST
AKRON OH
44305-3040
US

IV. Provider business mailing address

2282 NEWTON ST
AKRON OH
44305-3040
US

V. Phone/Fax

Practice location:
  • Phone: 330-794-9700
  • Fax: 330-794-6791
Mailing address:
  • Phone: 330-794-9700
  • Fax: 330-794-6791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number5302
License Number State

VIII. Authorized Official

Name: DR. ANDREW M. DODD
Title or Position: OPTOMETRIST
Credential: O.D.
Phone: 330-794-9700