Provider Demographics
NPI:1093884595
Name:DOTSON, RODNEY NORMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:NORMAN
Last Name:DOTSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 52947
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79159-2947
Mailing Address - Country:US
Mailing Address - Phone:806-356-6002
Mailing Address - Fax:806-373-9666
Practice Address - Street 1:1800 S HUGHES ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79102-2651
Practice Address - Country:US
Practice Address - Phone:806-356-6002
Practice Address - Fax:806-373-9666
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9988207Q00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00R616Medicare ID - Type Unspecified