Provider Demographics
NPI:1639262355
Name:DODD, MICHAEL EUGENE (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EUGENE
Last Name:DODD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 COUNTY ROAD 1505
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35058
Mailing Address - Country:US
Mailing Address - Phone:256-347-0665
Mailing Address - Fax:256-739-4390
Practice Address - Street 1:525 MAIN AVE. S.W.
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055
Practice Address - Country:US
Practice Address - Phone:256-734-7315
Practice Address - Fax:256-739-4390
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051506982OtherPROVIDER NUMBER
ALU89863Medicare UPIN