Provider Demographics
NPI:1033195318
Name:HODSON, DON W (MD)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:W
Last Name:HODSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 S FREEBORN
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:KS
Mailing Address - Zip Code:66861-1256
Mailing Address - Country:US
Mailing Address - Phone:620-382-3722
Mailing Address - Fax:620-382-3851
Practice Address - Street 1:537 S FREEBORN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:KS
Practice Address - Zip Code:66861-1243
Practice Address - Country:US
Practice Address - Phone:620-382-3722
Practice Address - Fax:620-382-3851
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04 18728207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100170600DMedicaid
B91017Medicare UPIN
KS100170600DMedicaid
041698Medicare ID - Type Unspecified