Healthcare Provider Details

I. General information

NPI: 1447284484
Provider Name (Legal Business Name): MICHAEL HODGESON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 MIDDLE CREEK RD STE 260
SEVIERVILLE TN
37862-3055
US

IV. Provider business mailing address

1130 MIDDLE CREEK RD STE 260
SEVIERVILLE TN
37862-3055
US

V. Phone/Fax

Practice location:
  • Phone: 865-428-7586
  • Fax: 865-428-8671
Mailing address:
  • Phone: 865-428-7586
  • Fax: 865-428-8671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD0000064011
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: