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General NPI Number Information
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NPI Number | 1861464844
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Entity Type | Individual
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Provider Name | DOUGLAS R DODSON D.O.
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Gender | Male
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 04/28/2017
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Provider Practice Location Address
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Address Line | 2301 INDIAN WELLS RD SUITE A
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City | ALAMOGORDO
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State | NM
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Zip | 88310-4607
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Country | US
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Telephone | 575-434-0639
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Fax | 575-434-4148
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Provider Business Mailing Address
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Address Line | 2301 INDIAN WELLS RD SUITE A
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City | ALAMOGORDO
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State | NM
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Zip | 88310-4607
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Country | US
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Telephone | 575-434-0639
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Fax | 575-434-4148
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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 | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | A-101394
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | A-101394
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License Number State | NM
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