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NPI 1619020401

NPI 1619020401 : JOHN EDWIN DODD JR. MD : FLOWOOD, MS

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General NPI Number Information
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    NPI Number           |    1619020401
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    Entity Type          |    Individual 
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    Provider Name        |    JOHN EDWIN DODD JR. MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/18/2007
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    Last Update Date     |    12/17/2025
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Provider Practice Location Address
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    Address Line         |    2470 FLOWOOD DR 
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    City                 |    FLOWOOD
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    State                |    MS
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    Zip                  |    39232-9019
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    Country              |    US
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    Telephone            |    601-664-1213
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    Fax                  |    601-932-8869
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Provider Business Mailing Address
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    Address Line         |    2470 FLOWOOD DR 
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    City                 |    FLOWOOD
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    State                |    MS
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    Zip                  |    39232-9019
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    Country              |    US
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    Telephone            |    601-664-1213
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    Fax                  |    601-932-8869
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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        |    207LP2900X
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    Taxonomy Name        |    Pain Medicine (Anesthesiology) Physician
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    License Number       |    10764
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    License Number State |    MS
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Taxonomy #2
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    Taxonomy Code        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    10764
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    License Number State |    MS
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