James Carlisle Dodson, MD
Individual provider Active NPI Internal Medicine Physician · Russellville, KY
NPI 1437158243 · NPPES record last updated Feb 12, 2008
Key facts
- NPI
- 1437158243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 19089 (KY)
- Practice address
- 147 E 5TH St
Russellville, KY 42276-1903 - Phone
- (270) 726-8331
- Fax
- (270) 725-9267
- NPI assigned
- Jul 14, 2005
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Interoperability endpoints
- vrn2435@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 19089 | KY | Yes |
Addresses
Primary practice location
147 E 5TH St
Russellville, KY 42276-1903
Mailing address
147 E 5TH St
Russellville, KY 42276-1903
Phone (270) 726-8331
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64190895 | Medicaid | KY |
Other providers in Russellville, KY
- Creekwood Place Opco LLC
- Cumberland Plastic Surgery PLLC
- Darla Sherrod Barrow
- David R. Whitley
- Erin Deans
- Ronald B Elder
- Adam Wesley Ellis
- Daniel Lee Emery
- Fast Pace Kentucky, PLLC
- First Steps Wellness LLC
All providers in Russellville, KY · Internal Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.