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NPI Code Detail

MEDICARE: DR. AMBER CATHLEEN DODGEN MD

MEDICARE: DR. AMBER CATHLEEN DODGEN MD
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
1208000000XPediatrics Physician89210GA

General Provider Information

NPI Number : 1336438845
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMBER CATHLEEN DODGEN MD
Provider Business Mailing Address
First Line : 3702 2ND AVE
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-7408
Country : US
Telephone Number : 706-507-9209
Fax Number :
Provider Business Practice Location Address
First Line : 3702 2ND AVE
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-7408
Country : US
Telephone Number : 706-507-9209
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2011
Last Update Date : 12/20/2024

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