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NPI Code Detail

MEDICARE: MELISSA KAY HODGES PA-C

MEDICARE: MELISSA KAY 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
1363AS0400XSurgical Physician Assistant3277SC

General Provider Information

NPI Number : 1437410594
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA KAY HODGES PA-C
Provider Business Mailing Address
First Line : BUILDING 9205 WATKINS AVE
Second Line :
City : FORT BENNING
State : GA
Zip : 31905
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 222 E MEDICAL LN STE 101
Second Line :
City : WEST COLUMBIA
State : SC
Zip : 29169-4850
Country : US
Telephone Number : 803-739-3660
Fax Number : 803-739-3663
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2012
Last Update Date : 11/06/2020

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