Provider Demographics
NPI:1346245289
Name:DODSON, VERNE HAROLD (MD)
Entity Type:Individual
Prefix:
First Name:VERNE
Middle Name:HAROLD
Last Name:DODSON
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 1:1012 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-2556
Mailing Address - Country:US
Mailing Address - Phone:937-866-0741
Mailing Address - Fax:937-866-8861
Practice Address - Street 1:1012 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-2556
Practice Address - Country:US
Practice Address - Phone:937-866-0741
Practice Address - Fax:937-866-8861
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH28218207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0959333Medicaid
OHD28218OtherCHOICE CARE
OH179400OtherONE HEALTH
OH1763398002OtherCIGNA
OH862131OtherFIRST HEALTH
OHD52147OtherHUMANA CHOICE CARE
OH080024271OtherRAILROAD MEDICARE
OH0361500001OtherMEDICARE DME
OH080024271OtherRAILROAD MEDICARE
OH0959333Medicaid