Provider Demographics
NPI:1932545332
Name:DODDS, RONDA FAYE (LDO)
Entity type:Individual
Prefix:
First Name:RONDA
Middle Name:FAYE
Last Name:DODDS
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 PATTERSON ST
Mailing Address - Street 2:DOCTORS PAVILION SUITE 104
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2120
Mailing Address - Country:US
Mailing Address - Phone:615-329-1731
Mailing Address - Fax:
Practice Address - Street 1:1916 PATTERSON ST
Practice Address - Street 2:DOCTORS PAVILION SUITE 104
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2120
Practice Address - Country:US
Practice Address - Phone:615-329-1731
Practice Address - Fax:615-329-1732
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1640156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician