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Contact Information

EDWARD A DODGE, PA
5325 FARAON ST
SAINT JOSEPH, MO64506-3488
 Phone: 816-271-6122
 Fax: 816-271-6019
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for EDWARD A DODGE · (Male)

NPI # 1043468093
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 09/03/2008
Last updated 03/17/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • KS License # T-02280
  • KS Medicaid 200577260A
Hospital affiliation(s)
  • GREAT BEND REGIONAL HOSPITAL - (Acute Care)
    514 CLEVELAND STREET
    GREAT BEND, KS 67530
  • MEADE DISTRICT HOSPITAL - (Critical Access)
    510 E CARTHAGE
    MEADE, KS 67864
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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