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General NPI Number Information
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NPI Number | 1639597610
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Entity Type | Individual
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Provider Name | IAN B DODSON
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Gender | Male
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Dates
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Enumeration Date | 04/07/2014
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 49 JESSE HILL JR DR SE
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City | ATLANTA
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State | GA
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Zip | 30303-3049
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Country | US
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Telephone | 404-251-8865
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Fax |
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Provider Business Mailing Address
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Address Line | 1238 N. BROAD STREET APARTMENT A
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City | NEW ORLEANS
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State | LA
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Zip | 70119
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Country | US
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Telephone | 256-541-1765
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 078018
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD24028
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License Number State | ME
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