person
Kevin C Dodson
Foot & Ankle Surgery Podiatrist in East Moline, Illinois
NPI 1629076559

Kevin C Dodson is a Foot & Ankle Surgery Podiatrist based in East Moline, IL and is specialized in Foot & Ankle Surgery. Kevin C Dodson practices in East Moline, IL. The NPI Number for Kevin C Dodson is 1629076559 and holds a License No. 016004304 (Illinois).

The current practice location address for Kevin C Dodson is 1620 9Th St, East Moline, IL and can be reached out via phone at 309-755-3809 and via fax at 309-755-3860.

Location: 1620 9Th St, East Moline, IL, 61244-2120
person
Provider Profile Details
NPI Number
1629076559
Provider Name
Kevin C Dodson
Credential
Provider Entity Type
Individual
Gender
Male
Address
1620 9Th St, East Moline, IL, 61244-2120
Phone Number
309-755-3809
Fax Number
309-755-3860
Provider Enumeration Date
07/13/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0060201286 01 IL BLUE CROSS AND BLUE SHIEL
0436154 01 IA IME
363660257003 01 IA TRICARE
P00204462 01 IA MEDICARE RAILROAD
016004304 05 IL
020110 01 IL HEALTH ALLIANCE
36473 01 IA WELLMARK BLUE CROSS BLUE SHIELD
326507258 01 IL TRICARE
480007485 01 IL MEDICARE RAILROAD
IL0101 01 IL UNITED HEALTHCARE
I12453 01 IA MEDICARE
IA0102 01 IA UNITED HEALTHCARE
institution
Provider Business Practice Location Address Details
Address
1620 9Th St
City
State
Zip
61244-2120
Phone Number
309-755-3809
Fax Number
309-755-3860
person
Provider Business Mailing Address Details
Address
1620 9Th St
City
State
Zip
61244-2120
Phone Number
309-755-3809
Fax Number
309-755-3860
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
016004304 (Illinois)
Definition
Definition to come...
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