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NPI Code Detail

MEDICARE: MAVIS HODGES PA-C

MEDICARE:   MAVIS  HODGES  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant0010-11291NC

General Provider Information

NPI Number : 1326589490
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAVIS HODGES PA-C
Provider Business Mailing Address
First Line : 109 WRIGHT HILL DR
Second Line :
City : DURHAM
State : NC
Zip : 27712-9094
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 109 WRIGHT HILL DR
Second Line :
City : DURHAM
State : NC
Zip : 27712-9094
Country : US
Telephone Number : 540-598-4942
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2017
Last Update Date : 11/07/2023

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Directions to “ MAVIS HODGES PA-C” Practice Location

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