Provider Demographics
NPI:1982987343
Name:DODSON, SARAH ELAINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELAINE
Last Name:DODSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-3210
Mailing Address - Country:US
Mailing Address - Phone:417-667-6044
Mailing Address - Fax:
Practice Address - Street 1:900 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772-3210
Practice Address - Country:US
Practice Address - Phone:417-667-6044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010033601183500000X
KS1-14797183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist