Provider Demographics
NPI:1972995850
Name:DODSON, CLAIRE (PA-C)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:DODSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MONTGOMERY HWY
Mailing Address - Street 2:SUITE 125
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1842
Mailing Address - Country:US
Mailing Address - Phone:205-855-9595
Mailing Address - Fax:205-822-4733
Practice Address - Street 1:200 MONTGOMERY HWY
Practice Address - Street 2:SUITE 125
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35216-1842
Practice Address - Country:US
Practice Address - Phone:205-855-9595
Practice Address - Fax:205-822-4733
Is Sole Proprietor?:No
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1030363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant