Provider Demographics
NPI:1255300893
Name:HODES, HERBERT C (MD)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:C
Last Name:HODES
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 1:4840 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1601
Mailing Address - Country:US
Mailing Address - Phone:913-491-6878
Mailing Address - Fax:913-491-6808
Practice Address - Street 1:4840 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1601
Practice Address - Country:US
Practice Address - Phone:913-491-6878
Practice Address - Fax:913-491-6808
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-14447207VX0000X
MOR5071207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200106219Medicaid
KS100094500AMedicaid
KS100094500AMedicaid
KS100094500AMedicaid