MEDICARE: DR. THOMAS W HODGIN JR. MD

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	207R00000X	Internal Medicine Physician	9900249	NC

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	:	1508869538
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS W HODGIN JR. MD

Provider Business Mailing Address
First Line	:	1200 N ELM ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401-1004
Country	:	US
Telephone Number	:	336-832-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2630 WILLARD DAIRY RD
Second Line	:	SUITE 301
City	:	HIGH POINT
State	:	NC
Zip	:	27265-8351
Country	:	US
Telephone Number	:	336-884-3800
Fax Number	:	336-884-3801

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	11/28/2012

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