Provider Demographics
NPI:1760082275
Name:DODSON, HILLARY
Entity type:Individual
Prefix:
First Name:HILLARY
Middle Name:
Last Name:DODSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10220 N SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:SPERRY
Mailing Address - State:OK
Mailing Address - Zip Code:74073-4597
Mailing Address - Country:US
Mailing Address - Phone:605-448-6877
Mailing Address - Fax:
Practice Address - Street 1:700 W ROGERS BLVD
Practice Address - Street 2:
Practice Address - City:SKIATOOK
Practice Address - State:OK
Practice Address - Zip Code:74070-1035
Practice Address - Country:US
Practice Address - Phone:605-362-1602
Practice Address - Fax:605-362-1802
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5977183500000X
OK20046183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist