Healthcare Provider Details

I. General information

NPI: 1336085414
Provider Name (Legal Business Name): HENRY HODGE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 05/03/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7430 DECOY CIR
ANCHORAGE AK
99502-1965
US

IV. Provider business mailing address

7430 DECOY CIR
ANCHORAGE AK
99502-1965
US

V. Phone/Fax

Practice location:
  • Phone: 907-885-4760
  • Fax: 907-802-6100
Mailing address:
  • Phone: 907-885-4760
  • Fax: 907-802-6100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: