MEDICARE: DONALD F HODURSKI M.D.

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	207X00000X	Orthopaedic Surgery Physician	00005785	AL
2	207X00000X	Orthopaedic Surgery Physician	ME90799	FL
3	207X00000X	Orthopaedic Surgery Physician	01023439A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	200026240	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	510-07507	OTHER	AL	BCBS
4	0910073	OTHER	AL	UNITED HEALTHCARE
6	510-37186	OTHER	AL	BCBS

General Provider Information

NPI Number	:	1437118254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD F HODURSKI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 49
Second Line	:
City	:	FITZPATRICK
State	:	AL
Zip	:	36029-0049
Country	:	US
Telephone Number	:	334-301-2825
Fax Number	:	334-738-3260

Provider Business Practice Location Address
First Line	:	101 S UNION ST
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36130-3022
Country	:	US
Telephone Number	:	334-301-2825
Fax Number	:

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

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	01/15/2015

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