Provider Demographics
NPI:1710186572
Name:DODGENS, KARA JO (OD)
Entity Type:Individual
Prefix:DR
First Name:KARA
Middle Name:JO
Last Name:DODGENS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:15 SOUTHERN CENTER CT
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29642-1533
Mailing Address - Country:US
Mailing Address - Phone:864-722-1133
Mailing Address - Fax:864-343-2074
Practice Address - Street 1:15 SOUTHERN CENTER CT
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-1533
Practice Address - Country:US
Practice Address - Phone:864-722-1133
Practice Address - Fax:864-343-2074
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1476152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist