Provider Demographics
NPI:1295848729
Name:HODGSON, JEFFREY E (PHARMD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:E
Last Name:HODGSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 SUMMERFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-8511
Mailing Address - Country:US
Mailing Address - Phone:785-843-3268
Mailing Address - Fax:
Practice Address - Street 1:2336 RIDGE CT
Practice Address - Street 2:STE C
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66046-3983
Practice Address - Country:US
Practice Address - Phone:785-841-1950
Practice Address - Fax:785-841-1051
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-13251183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1-13251OtherSTATE PHARMACY LICENSE