Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 19793 | MS |
Y | 207W00000X | Ophthalmologist | MD.026383 | LA |
NPI | 1033310271 |
---|---|
Provider Name | Dr. Daniel Jack Dodson |
First Address | Hammond, LA 70404-2668 |
Second Address | Hammond, LA 70403-1475 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2007 |
Last Update Date | 08/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1057835 | (05) | LA |