Provider Demographics
NPI:1497022909
Name:DODSON, JAMES KURTEIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KURTEIS
Last Name:DODSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-2221
Mailing Address - Country:US
Mailing Address - Phone:812-882-3896
Mailing Address - Fax:812-882-0978
Practice Address - Street 1:505 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-2221
Practice Address - Country:US
Practice Address - Phone:812-882-3896
Practice Address - Fax:812-882-0978
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26024134A183500000X
IL051.295239183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist