Dodgen, Diane
Dodgen, Diane is an sole proprietor health care provider with primary practice located at 315 E Ash St , Perry FL 32347-2029. She recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Primary Care, Allopathic & Osteopathic Physicians / Internal Medicine. Ambulatory Health Care Facilities / Primary Care is her primary health care specialty. Dodgen, Diane can be contacted via phone (850) 584-3278.Contact Information
Primary practice address
315 E Ash St
Perry FL 32347-2029
Phone: (850) 584-3278
Fax: (850) 584-8171
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Ambulatory Health Care Facilities / Primary Care | 261QP2300X | ME99971 | Florida |
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME99971 | Florida |
Profile Details
NPI number | 1134117385 |
---|---|
LBN Legal business name | Dodgen, Diane |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Oct 12th, 2005 |
Last updated | Mar 17th, 2017 - about 7 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 | 1134117385 | NPPES |
Florida | MEDICAID | 279528100 |
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