MEDICARE: DR. JOHN J HODGE D.M.D., M.S.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	2731-93	MS

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	:	1336218833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN J HODGE D.M.D., M.S.

Provider Business Mailing Address
First Line	:	4227 POPLAR SPRINGS DR
Second Line	:
City	:	MERIDIAN
State	:	MS
Zip	:	39305-3311
Country	:	US
Telephone Number	:	601-482-7700
Fax Number	:	601-482-0076

Provider Business Practice Location Address
First Line	:	4227 POPLAR SPRINGS DR
Second Line	:
City	:	MERIDIAN
State	:	MS
Zip	:	39305-3311
Country	:	US
Telephone Number	:	601-482-7700
Fax Number	:	601-482-0076

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	06/18/2008

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