MEDICARE: DR. GENE K. HODGES 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
1	207QA0000X	Adolescent Medicine (Family Medicine) Physician	M4937	ID
2	207Q00000X	Family Medicine Physician	M4937	ID
3	207QA0505X	Adult Medicine Physician	M4937	ID

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	1117710	OTHER	ID	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316055320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GENE K. HODGES M.D.

Provider Business Mailing Address
First Line	:	2065 E 17TH ST STE A
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-8042
Country	:	US
Telephone Number	:	208-522-3301
Fax Number	:	208-522-3414

Provider Business Practice Location Address
First Line	:	2065 E 17TH ST
Second Line	:	SUITE A
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-8042
Country	:	US
Telephone Number	:	208-522-3301
Fax Number	:	208-522-3414

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	03/13/2026

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Directions to “ DR. GENE K. HODGES M.D.” Practice Location

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