Active NPI
Larry a Dodd MD PLLC
- Otolaryngology Physician
- Wheeling, WV
National Provider Identifier
1356548580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- Legal business name
- LARRY A DODD MD PLLC
- Practice address
- 30 Medical Park
Suite 223
Wheeling, WV 26003-6391 - Phone
- (304) 234-2060
- Fax
- (304) 234-2070
- NPI assigned
- Jun 29, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Larry A Dodd, MD
- Title
- President
- Phone
- (304) 233-2455
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | Primary |
Addresses
Primary practice location
30 Medical Park
Suite 223
Wheeling, WV 26003-6391
Mailing address
PO Box 6847
Wheeling, WV 26003-0666
Phone (304) 233-2455
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0419738 | Medicaid | OH | |
| 1802957000 | Medicaid | WV |
National Provider Directory
National Provider DirectoryLocations
20 Medical Park
Ste 223
Wheeling, WV 26003
Phone (304) 234-2061
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183075200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1192752000000",
"number": "1356548580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6847",
"city": "WHEELING",
"state": "WV",
"postal_code": "260030666",
"telephone_number": "304-233-2455",
"fax_number": "304-233-6073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 MEDICAL PARK",
"address_2": "SUITE 223",
"city": "WHEELING",
"state": "WV",
"postal_code": "260036391",
"telephone_number": "304-234-2060",
"fax_number": "304-234-2070"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LARRY A DODD MD PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-06-29",
"last_updated": "2007-10-19",
"status": "A",
"authorized_official_last_name": "DODD",
"authorized_official_first_name": "LARRY",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "304-233-2455",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Otolaryngology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0419738",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1802957000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wheeling, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.