MR. Kenneth R Dodge, RPAC

NPI #1952366601 in East Hampton, New York

Provider Information

NPI Number: 1952366601
Entity Type: Individual
Name: MR. Kenneth R Dodge, RPAC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: RPAC
Enumeration Date: Apr 18, 2006
Last Updated: Apr 12, 2008

Practice Location

Address: 200 PANTIAGO PLACE
Address 2: STE J
City: East Hampton
State: New York
ZIP Code: 11937
Phone: (631) 324-7700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary
Physician Assistant - Medical — Medical	363AM0700X

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