Provider Demographics
NPI:1912724170
Name:DODSON, DARIUS KEVON
Entity type:Individual
Prefix:
First Name:DARIUS
Middle Name:KEVON
Last Name:DODSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8404 E 91ST TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64138-4353
Mailing Address - Country:US
Mailing Address - Phone:832-771-1543
Mailing Address - Fax:
Practice Address - Street 1:7500 COLLEGE BLVD UNIT 569
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-4035
Practice Address - Country:US
Practice Address - Phone:816-309-1288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSTHR-073723225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist