Dodge, Ethan

Dodge, Ethan is an individual health care provider with primary practice located at 1919 E Thomas Rd Phoenix Children'S Hospital, Phoenix AZ 85016. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Dodge, Ethan can be contacted via phone (602) 546-2923.

Contact Information

Primary practice address
1919 E Thomas Rd Phoenix Children'S Hospital Phoenix AZ 85016
Phone: (602) 546-2923
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 60154 Arizona

Profile Details

NPI number 1962938464
LBN Legal business name Dodge, Ethan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2017
Last updated Jul 27th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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