MEDICARE: DR. HEATHER B HODGIN AU.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	231H00000X	Audiologist	4677	NC

General Provider Information

NPI Number	:	1841498268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEATHER B HODGIN AU.D.

Provider Business Mailing Address
First Line	:	321 W WENDOVER AVE
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27408-8401
Country	:	US
Telephone Number	:	336-379-9445
Fax Number	:	336-691-1704

Provider Business Practice Location Address
First Line	:	321 W WENDOVER AVE
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27408-8401
Country	:	US
Telephone Number	:	336-379-9445
Fax Number	:	336-691-1704

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

Provider Enumeration Date	:	07/06/2007
Last Update Date	:	07/08/2007

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