Provider Demographics
NPI:1134114481
Name:HODGDON, ALAN KENT (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:KENT
Last Name:HODGDON
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 1:4800 FRIENDSHIP AVE
Mailing Address - Street 2:EMERG MED WESTERN PENNA HOSPITAL
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1722
Mailing Address - Country:US
Mailing Address - Phone:412-578-5442
Mailing Address - Fax:412-578-1144
Practice Address - Street 1:4800 FRIENDSHIP AVE
Practice Address - Street 2:EMERG MED WESTERN PENNA HOSPITAL
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1722
Practice Address - Country:US
Practice Address - Phone:412-578-5442
Practice Address - Fax:412-578-1144
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042112L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012152230010Medicaid
WV3810016394Medicaid
PAE38337Medicare UPIN
PA930122351Medicare PIN
PA578509NJRMedicare PIN
PA0012152230010Medicaid