MEDICARE: GREGORY H DODSON

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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1528013968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREGORY H DODSON

Provider Business Mailing Address
First Line	:	PO BOX 1211
Second Line	:
City	:	LEBANON
State	:	TN
Zip	:	37088-1211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 SIGNATURE PL STE 102
Second Line	:
City	:	LEBANON
State	:	TN
Zip	:	37087-3377
Country	:	US
Telephone Number	:	615-453-6228
Fax Number	:	615-453-6230

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GREGORY H DODSON
Credential	:
Telephone Number	:	615-453-6228

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	05/04/2012

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