Provider Demographics
NPI:1417120569
Name:HODGSON, JONI (DO)
Entity Type:Individual
Prefix:
First Name:JONI
Middle Name:
Last Name:HODGSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1341 CANTON RD STE A
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-6056
Mailing Address - Country:US
Mailing Address - Phone:770-422-0517
Mailing Address - Fax:678-638-7015
Practice Address - Street 1:1505 NORTHSIDE BLVD STE 1300
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7624
Practice Address - Country:US
Practice Address - Phone:770-771-6400
Practice Address - Fax:678-638-7015
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA865612083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine