Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0201X | Gynecologic Oncologist | 12263 | MS |
N | 207VX0201X | Gynecologic Oncologist | 19207 | TN |
Y | 207VX0201X | Gynecologic Oncologist | 293511-1205 | UT |
NPI | 1275570467 |
---|---|
Provider Name | Dr. Mark Kane Dodson |
First Address | Salt Lake City, UT 84141-3028 |
Second Address | Salt Lake City, UT 84132-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 20/10/2021 |