Healthcare Provider Details

I. General information

NPI: 1497076624
Provider Name (Legal Business Name): BRIAN NEIL HODGES D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2010
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHRISTUS ST. VINCENT SURGICALIST GROUP 455 ST. MICHAEL'S DRIVE
SANTA FE NM
87505-7601
US

IV. Provider business mailing address

CHRISTUS ST. VINCENT SURGICALIST GROUP 455 ST. MICHAEL'S DRIVE
SANTA FE NM
87505-7601
US

V. Phone/Fax

Practice location:
  • Phone: 505-913-3975
  • Fax:
Mailing address:
  • Phone: 505-913-3975
  • Fax: 505-986-8001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberDO2025-0160
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: