Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 35075039 | OH |
NPI | 1003803388 |
---|---|
Provider Name | Dr. Craig Howard Dodrill |
First Address | Athens, OH 45701-2857 |
Second Address | Athens, OH 45701-2857 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2005 |
Last Update Date | 09/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2257034 | (05) | OH |
H39722 | (02) |