Healthcare Provider Details

I. General information

NPI: 1821928037
Provider Name (Legal Business Name): BRANDON HODGES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 N DUPONT HWY
NEW CASTLE DE
19720-1160
US

IV. Provider business mailing address

2034 CARMEL DR
JAMISON PA
18929-1437
US

V. Phone/Fax

Practice location:
  • Phone: 302-255-2700
  • Fax:
Mailing address:
  • Phone: 267-441-2638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: