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NPI Code Detail

MEDICARE: DR. DANIEL KENNETH HODGE JR. M.D.

MEDICARE: DR. DANIEL KENNETH HODGE JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician0101256801VA
2207R00000XInternal Medicine PhysicianMD467395PA

General Provider Information

NPI Number : 1295173235
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL KENNETH HODGE JR. M.D.
Provider Business Mailing Address
First Line : 1800 CARLISLE RD
Second Line :
City : CAMP HILL
State : PA
Zip : 17011-5909
Country : US
Telephone Number : 177-695-6104
Fax Number :
Provider Business Practice Location Address
First Line : 1800 CARLISLE RD
Second Line :
City : CAMP HILL
State : PA
Zip : 17011-5909
Country : US
Telephone Number : 177-695-6104
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2013
Last Update Date : 07/29/2020

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