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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255327060 | NPPES |
| Kentucky | MEDICAID | 64053192 |
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