Provider Demographics
NPI:1033214911
Name:HODGES, WALTER J JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:J
Last Name:HODGES
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:3620 JOSEPH SIEWICK DR
Mailing Address - Street 2:400
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-1756
Mailing Address - Country:US
Mailing Address - Phone:703-264-7801
Mailing Address - Fax:703-264-7807
Practice Address - Street 1:3620 JOSEPH SIEWICK DR
Practice Address - Street 2:400
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-1756
Practice Address - Country:US
Practice Address - Phone:703-264-7801
Practice Address - Fax:703-264-7807
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2011-09-13
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Provider Licenses
StateLicense IDTaxonomies
VA0101019262207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF54851Medicare UPIN