Provider Demographics
NPI:1609396845
Name:DODD, JACOB GERALD (DO)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:GERALD
Last Name:DODD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 BARROW ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3631
Mailing Address - Country:US
Mailing Address - Phone:907-276-1315
Mailing Address - Fax:
Practice Address - Street 1:636 BARROW ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3631
Practice Address - Country:US
Practice Address - Phone:907-276-1315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1928207N00000X
AK241077207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology