Provider Demographics
NPI:1801866645
Name:DODD-O, MARCUS ANDRE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:ANDRE
Last Name:DODD-O
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 1:1337 KILLBRICKEN CIR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-3087
Mailing Address - Country:US
Mailing Address - Phone:386-615-6858
Mailing Address - Fax:
Practice Address - Street 1:3750 ROSCOMMON DR
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-2849
Practice Address - Country:US
Practice Address - Phone:386-615-6858
Practice Address - Fax:386-615-7261
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0022019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist