Dodge, Renee L

Dodge, Renee L is an individual health care provider with primary practice located at 289 Ireland Ave Bldg 851 Va Clinic, Fort Knox KY 40121-5111. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Dodge, Renee L can be contacted via phone (502) 624-0235.

Contact Information

Primary practice address
289 Ireland Ave Bldg 851 Va Clinic Fort Knox KY 40121-5111
Phone: (502) 624-0235
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X KY02722 Kentucky

Profile Details

NPI number 1255327060
LBN Legal business name Dodge, Renee L
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2005
Last updated Nov 7th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255327060 NPPES
Kentucky MEDICAID 64053192

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