Provider Demographics
NPI:1790371953
Name:DODD, ALAN E VIII (PD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:E
Last Name:DODD
Suffix:VIII
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 MARKET TRCE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72908-8677
Mailing Address - Country:US
Mailing Address - Phone:479-646-5505
Mailing Address - Fax:479-649-7535
Practice Address - Street 1:2507 MARKET TRCE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72908-8677
Practice Address - Country:US
Practice Address - Phone:479-646-5505
Practice Address - Fax:479-649-7535
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD066971835P2201X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care