Healthcare Provider Details

I. General information

NPI: 1649462193
Provider Name (Legal Business Name): DENNIS DOODY MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 08/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 NORTHWOODS BLVD
COLUMBUS OH
43235-4711
US

IV. Provider business mailing address

PO BOX 182255
COLUMBUS OH
43218-2255
US

V. Phone/Fax

Practice location:
  • Phone: 614-846-4588
  • Fax:
Mailing address:
  • Phone: 614-430-5731
  • Fax: 614-430-5742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DENNIS M DOODY
Title or Position: PRESIDENT
Credential: MD
Phone: 614-846-4588