| Thomas W. Dodson, Md Pc | |
|
2187 Sw Main St Suite 102 Portland OR 97205-1123 | |
| (503) 228-0370 | |
| (503) 228-6690 |
| Full Name | Thomas W. Dodson, Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2187 Sw Main St, Portland, Oregon |
| Authorized Official Name and Position | Thomas William Dodson (PRESIDENT) |
| Authorized Official Contact | 5032280370 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas W. Dodson, Md Pc 2187 Sw Main St Suite 102 Portland OR 97205-1123 Ph: (503) 228-0370 | Thomas W. Dodson, Md Pc 2187 Sw Main St Suite 102 Portland OR 97205-1123 Ph: (503) 228-0370 |
| NPI Number | 1609065176 |
|---|---|
| Provider Enumeration Date | 10/19/2007 |
| Last Update Date | 10/19/2007 |
| Medicare PECOS PAC ID | 9133117013 |
|---|---|
| Medicare Enrollment ID | O20040501000265 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609065176 | NPI | - | NPPES |
| 054515 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 17869 (Oregon) | Primary |
| Provider Name | Thomas W Dodson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790796332 PECOS PAC ID: 3476541350 Enrollment ID: I20040503000116 |
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