Healthcare Provider Details

I. General information

NPI: 1093733461
Provider Name (Legal Business Name): ELIZABETH H HODGES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 12/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 CAHABA RD STE 102
BIRMINGHAM AL
35223-2629
US

IV. Provider business mailing address

3300 CAHABA RD STE 102
BIRMINGHAM AL
35223-2629
US

V. Phone/Fax

Practice location:
  • Phone: 205-870-7292
  • Fax: 205-870-3639
Mailing address:
  • Phone: 205-870-7292
  • Fax: 205-870-3639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4473
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: