Healthcare Provider Details

I. General information

NPI: 1578471322
Provider Name (Legal Business Name): CARSON HODSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 GREENGLEN CT
LANCASTER OH
43130-6520
US

IV. Provider business mailing address

1760 GREENGLEN CT
LANCASTER OH
43130-6520
US

V. Phone/Fax

Practice location:
  • Phone: 740-279-5864
  • Fax:
Mailing address:
  • Phone: 740-279-5864
  • 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 State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: