Healthcare Provider Details

I. General information

NPI: 1821027137
Provider Name (Legal Business Name): DURWOOD M. HODGES JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29810 AL HIGHWAY 71
BRYANT AL
35958-5240
US

IV. Provider business mailing address

309 TAYLOR ST
SCOTTSBORO AL
35768-2421
US

V. Phone/Fax

Practice location:
  • Phone: 256-597-4114
  • Fax: 256-597-4115
Mailing address:
  • Phone: 256-259-5313
  • Fax: 256-259-4923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.9279
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: