Dodgen, Diane

Dodgen, Diane is an sole proprietor health care provider with primary practice located at 315 E Ash St , Perry FL 32347-2029. She recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Primary Care, Allopathic & Osteopathic Physicians / Internal Medicine. Ambulatory Health Care Facilities / Primary Care is her primary health care specialty. Dodgen, Diane can be contacted via phone (850) 584-3278.

Contact Information

Primary practice address
315 E Ash St Perry FL 32347-2029
Phone: (850) 584-3278
Fax: (850) 584-8171
Website:
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Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X ME99971 Florida
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME99971 Florida

Profile Details

NPI number 1134117385
LBN Legal business name Dodgen, Diane
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 12th, 2005
Last updated Mar 17th, 2017 - about 9 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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Identifiers

StateTypeNumberIssuer
All States NPI 1134117385 NPPES
Florida MEDICAID 279528100

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