Healthcare Provider Details

I. General information

NPI: 1477488260
Provider Name (Legal Business Name): BRITTANY HODGES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4717 SAINT ANTOINE ST
DETROIT MI
48201-1423
US

IV. Provider business mailing address

4717 SAINT ANTOINE ST
DETROIT MI
48201-1423
US

V. Phone/Fax

Practice location:
  • Phone: 313-577-8900
  • Fax:
Mailing address:
  • Phone: 313-577-8900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number4351057111
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: