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NPI Code Detail

MEDICARE: DR. MICHAEL JOSEPH HODOVANIC III OD

MEDICARE:  DR. MICHAEL JOSEPH HODOVANIC III OD
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
1152W00000XOptometrist3706OH

General Provider Information

NPI Number : 1326037557
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL JOSEPH HODOVANIC III OD
Provider Business Mailing Address
First Line : 24 COMPTON RD
Second Line : SUITE 204
City : CINCINNATI
State : OH
Zip : 45216-1000
Country : US
Telephone Number : 513-821-5710
Fax Number : 513-821-5711
Provider Business Practice Location Address
First Line : 24 COMPTON RD
Second Line : SUITE 204
City : CINCINNATI
State : OH
Zip : 45216-1000
Country : US
Telephone Number : 513-821-5710
Fax Number : 513-821-5711
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 07/08/2007

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Directions to “ DR. MICHAEL JOSEPH HODOVANIC III OD” Practice Location

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