Provider Demographics
NPI:1275755688
Name:DODD, RICHARD PAYNE (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:PAYNE
Last Name:DODD
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 1:1701 MAIN AVE SW STE A
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-5385
Mailing Address - Country:US
Mailing Address - Phone:256-737-0880
Mailing Address - Fax:256-737-9191
Practice Address - Street 1:1701 MAIN AVE SW STE A
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-5385
Practice Address - Country:US
Practice Address - Phone:256-737-0880
Practice Address - Fax:256-737-9191
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL-2791207Q00000X
AL28382207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL129297Medicaid
AL1275755688OtherUNITED HEALTH CARE
AL51109140OtherBCBS
AL51032953OtherBCBS OF ALABAMA
AL102I089982OtherMEDICARE ID
AL1598717381OtherMEDICAID GROUP NPI
ALE869OtherMEDICARE GROUP
ALP00742760OtherMEDICARE RR