Provider Demographics
NPI:1083611859
Name:DODDY, KARYN RAE (MD)
Entity Type:Individual
Prefix:DR
First Name:KARYN
Middle Name:RAE
Last Name:DODDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9030 W SAHARA AVE
Mailing Address - Street 2:# 249
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5744
Mailing Address - Country:US
Mailing Address - Phone:702-964-1018
Mailing Address - Fax:702-487-7113
Practice Address - Street 1:138 S RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-5330
Practice Address - Country:US
Practice Address - Phone:702-862-0200
Practice Address - Fax:023-860-3077
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2023-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV9216208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018331Medicaid
NV002018331Medicaid
NV32653Medicare PIN