Provider Demographics
NPI:1003899436
Name:HODKIN, MICHAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:HODKIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9202 N MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1800
Mailing Address - Country:US
Mailing Address - Phone:317-841-2020
Mailing Address - Fax:317-570-7433
Practice Address - Street 1:5091 W BETHEL AVE STE 150
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-8511
Practice Address - Country:US
Practice Address - Phone:317-841-2020
Practice Address - Fax:317-570-7433
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2024-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01042523A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100387770Medicaid
IN151560E6Medicare PIN
F36321Medicare UPIN