MEDICARE: SOUTHERN PAIN AND REGENERATIVE MEDICINE PC

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	2085R0204X	Vascular & Interventional Radiology Physician
2	363LF0000X	Family Nurse Practitioner
3	363A00000X	Physician Assistant
4	208VP0014X	Interventional Pain Medicine Physician	MD20801	TN

General Provider Information

NPI Number	:	1841799707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN PAIN AND REGENERATIVE MEDICINE PC

Provider Business Mailing Address
First Line	:	8990 GERMANTOWN RD STE B
Second Line	:
City	:	OLIVE BRANCH
State	:	MS
Zip	:	38654-8532
Country	:	US
Telephone Number	:	901-350-0678
Fax Number	:	901-350-0677

Provider Business Practice Location Address
First Line	:	8990 GERMANTOWN RD STE B
Second Line	:
City	:	OLIVE BRANCH
State	:	MS
Zip	:	38654-8532
Country	:	US
Telephone Number	:	662-775-0189
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	THOMAS HODGKISS
Credential	:	MD
Telephone Number	:	901-350-0678

Provider Enumeration Date	:	02/06/2018
Last Update Date	:	01/12/2026

Similar Medicare Providers

1760411813 — WARREN T KWOK M.D.
Practice Location Address:

8990 GERMANTOWN RD
OLIVE BRANCH, MS
38654-8532

Practice Phone: 662-893-1160
Practice Fax: 662-893-1166

1912431834 — JENNIFER M ASHLEY DO
Practice Location Address:

8990 GERMANTOWN RD
OLIVE BRANCH, MS
38654-8532

Practice Phone: 662-893-1160
Practice Fax: 662-893-1166

1063307650 — SOUTHERN VASCULAR AND PAIN SURGERY CENTER OLIVE BRANCH LLC
Practice Location Address:

8990 GERMANTOWN RD STE A
OLIVE BRANCH, MS
38654-8532

Practice Phone: 901-350-0678
Practice Fax:

1346199932 — JULIA LYNN SMITH FNP
Practice Location Address:

1212 HIGHWAY 305 N
OLIVE BRANCH, MS
38654-9074

Practice Phone: 901-351-3829
Practice Fax:

1568312627 — THE BELMONT HOME CARE LLC
Practice Location Address:

6831 CRUMPLER BLVD STE 201
OLIVE BRANCH, MS
38654-2055

Practice Phone: 662-812-6787
Practice Fax: 662-812-6787

1912866435 — SEEDS OF JOY ACADEMY, LLC
Practice Location Address:

7178 RAVEN LN
OLIVE BRANCH, MS
38654-1475

Practice Phone: 901-334-7683
Practice Fax:

Directions to “SOUTHERN PAIN AND REGENERATIVE MEDICINE PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.