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General NPI Number Information
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NPI Number | 1962477802
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Entity Type | Individual
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Provider Name | BENITA JO DOUGHTY HODGES PT
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Gender | Female
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 02/15/2008
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Provider Practice Location Address
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Address Line | 303 LOVERS LN
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City | BOWLING GREEN
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State | KY
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Zip | 42103-7935
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Country | US
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Telephone | 270-781-5150
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Fax | 270-781-2392
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Provider Business Mailing Address
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Address Line | 303 LOVERS LN
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City | BOWLING GREEN
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State | KY
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Zip | 42103-7935
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Country | US
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Telephone | 270-781-5150
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Fax | 270-781-2392
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1715
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 002893
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 0000002608
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License Number State | TN
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