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1548277593

NPI Code Detail

MEDICARE: WILLIAM HAROLD DODSON III MD

MEDICARE: WILLIAM HAROLD DODSON III 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
1	207Q00000X	Family Medicine Physician	95-225	NM
2	207Q00000X	Family Medicine Physician	DR.0047338	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548277593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM HAROLD DODSON III MD

Provider Business Mailing Address
First Line	:	PO BOX 9049
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80301-9049
Country	:	US
Telephone Number	:	303-415-8900
Fax Number	:	303-443-6476

Provider Business Practice Location Address
First Line	:	1645 BROADWAY
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80302-6218
Country	:	US
Telephone Number	:	303-415-8900
Fax Number	:	303-443-6476

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	09/29/2022

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Directions to “ WILLIAM HAROLD DODSON III MD” Practice Location

Language	Start Address	Practice Location

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