Provider Demographics
NPI:1033160502
Name:DODDS, JULIE ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:DODDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:717 S STATE ST STE 900
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:MN
Mailing Address - Zip Code:56031-4400
Mailing Address - Country:US
Mailing Address - Phone:507-238-4949
Mailing Address - Fax:507-238-3365
Practice Address - Street 1:717 S STATE ST STE 900
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:MN
Practice Address - Zip Code:56031-4400
Practice Address - Country:US
Practice Address - Phone:507-238-4949
Practice Address - Fax:507-238-3365
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301058595207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1016065OtherMCLAREN HEALTH ADVANTAGE
MI1016065OtherMCLAREN HEALTH PLAN-COMMERCIAL
MI4224321OtherAETNA
MI200000001893OtherPHP
MI0M21440043OtherMEDICARE PLUS BLUE
MI200000001893OtherPHP FAMILYCARE
MI2003302131OtherBCBS/BCN
MI1016065OtherMCLAREN HEALTH PLAN-MEDICAID
MI4764980Medicaid
MI1016065OtherMCLAREN HEALTH PLAN-MEDICAID
MI200000001893OtherPHP FAMILYCARE