MEDICARE: KORTNEY HODGSON PA-C

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	363A00000X	Physician Assistant	PA6022	MA

General Provider Information

NPI Number	:	1477976611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KORTNEY HODGSON PA-C

Provider Business Mailing Address
First Line	:	20 WALNUT ST STE 100
Second Line	:
City	:	WELLESLEY
State	:	MA
Zip	:	02481-2104
Country	:	US
Telephone Number	:	617-466-3373
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 WALNUT ST STE 100
Second Line	:
City	:	WELLESLEY
State	:	MA
Zip	:	02481-2104
Country	:	US
Telephone Number	:	617-466-3373
Fax Number	:

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

Provider Enumeration Date	:	01/23/2014
Last Update Date	:	09/04/2025

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Directions to “ KORTNEY HODGSON PA-C” Practice Location

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