Provider Demographics
NPI:1316931447
Name:DODD, JAMES E II (DPM)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:DODD
Suffix:II
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 N BRADDOCK ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3969
Mailing Address - Country:US
Mailing Address - Phone:540-662-4572
Mailing Address - Fax:540-722-9519
Practice Address - Street 1:117 N BRADDOCK ST
Practice Address - Street 2:SUITE 150
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3969
Practice Address - Country:US
Practice Address - Phone:540-662-4572
Practice Address - Fax:540-722-9519
Is Sole Proprietor?:No
Enumeration Date:2005-09-03
Last Update Date:2010-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000819213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VACG4514OtherMEDICARE ID TYPE UNSPECIF
WV0677802Medicare PIN
VA480000314Medicare PIN
T95589Medicare UPIN