Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MT201007 | PA |
N | 207V00000X | Obstetrician & Gynecologist | R5855 | TX |
Y | 207VX0201X | Gynecologic Oncologist | 11745784-1205 | UT |
NPI | 1417216516 |
---|---|
Provider Name | Robert Lee Dood |
First Address | Salt Lake City, UT 84132 |
Second Address | Salt Lake City, UT 84132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2012 |
Last Update Date | 20/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
382456701 | (05) | TX |
382456702 | (05) | TX |