MEDICARE: DR. MORRISON HODGES MD

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
1	207RC0000X	Cardiovascular Disease Physician	21517	MN

General Provider Information

NPI Number	:	1336219435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MORRISON HODGES MD

Provider Business Mailing Address
First Line	:	920 E 28TH ST
Second Line	:	SUITE 40
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1139
Country	:	US
Telephone Number	:	612-863-3766
Fax Number	:	612-863-2490

Provider Business Practice Location Address
First Line	:	920 E 28TH ST
Second Line	:	SUITE 40
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1139
Country	:	US
Telephone Number	:	612-863-3766
Fax Number	:	612-863-2490

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	07/08/2007

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