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General NPI Number Information
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NPI Number | 1215463500
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Entity Type | Individual
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Provider Name | JUDD DOTSON RDCS-AE
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Gender | Male
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Dates
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Enumeration Date | 05/04/2017
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 87 N AVERY RD
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City | WATERFORD
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State | MI
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Zip | 48328-2903
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Country | US
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Telephone | 248-408-2215
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Fax |
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Provider Business Mailing Address
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Address Line | 87 N AVERY RD
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City | WATERFORD
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State | MI
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Zip | 48328-2903
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Country | US
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Telephone | 248-408-2215
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246XS1301X
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Taxonomy Name | Sonography Specialist/Technologist Cardiovascular
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License Number |
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License Number State |
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