MEDICARE: DR. JOSEPH T DODD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	35058426D	OH
2	208600000X	Surgery Physician	2010005697	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	020052286	OTHER	OH	RAI ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	1701078	OTHER	UNITED HEALTH CARE
2	602049	OTHER	FAMILY HEALTH PLAN
3	00789	OTHER	PARAMOUNT
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	4196773	OTHER	AETNA
6	000000223916	OTHER	ANTHEM
7	602049	OTHER	BUCKEYE COMMUNITY HEALTH PLAN
9	211400	OTHER	NATIONWIDE
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	341966854	OTHER	CIGNA

General Provider Information

NPI Number	:	1053314195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH T DODD M.D.

Provider Business Mailing Address
First Line	:	800 S ASH
Second Line	:
City	:	NEVADA
State	:	MO
Zip	:	64772
Country	:	US
Telephone Number	:	417-448-3644
Fax Number	:	417-448-3604

Provider Business Practice Location Address
First Line	:	800 S ASH
Second Line	:
City	:	NEVADA
State	:	MO
Zip	:	64772
Country	:	US
Telephone Number	:	417-448-3644
Fax Number	:	417-448-3604

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/15/2010

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Directions to “ DR. JOSEPH T DODD M.D.” Practice Location

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