MEDICARE: DR. DAVID SCOTT DODD PH.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	103TC0700X	Clinical Psychologist	839	OK

General Provider Information

NPI Number	:	1598859274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID SCOTT DODD PH.D.

Provider Business Mailing Address
First Line	:	4301 WILSON ST
Second Line	:
City	:	FORT SILL
State	:	OK
Zip	:	73503-4472
Country	:	US
Telephone Number	:	580-555-8283
Fax Number	:

Provider Business Practice Location Address
First Line	:	DEPARTMENT OF ARMY, USAMEDDAC
Second Line	:	ATTN: MCUA-CMH
City	:	FT. SILL
State	:	OK
Zip	:	73503-6300
Country	:	US
Telephone Number	:	580-442-4833
Fax Number	:	580-442-7604

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	02/19/2025

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