Provider Demographics
NPI:1679542153
Name:DODD, THOMAS WILLIAM (MD)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:WILLIAM
Last Name:DODD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:WILLIAM
Other - Last Name:DODD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2147 RIVERCHASE OFFICE RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244-1836
Mailing Address - Country:US
Mailing Address - Phone:205-403-8902
Mailing Address - Fax:205-982-0278
Practice Address - Street 1:2757 GREENSPRINGS HWY
Practice Address - Street 2:AMERICAN FAMILY CARE INC
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4903
Practice Address - Country:US
Practice Address - Phone:205-290-0088
Practice Address - Fax:205-945-1157
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16606207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51504985OtherBLUE CROSS BLUE SHIELD
AL000096716OtherMEDICARE PROVIDER# AFC
AL009956845Medicaid
AL080178934OtherRAILROAD MEDICARE
AL009956845Medicaid
AL080178934OtherRAILROAD MEDICARE