Provider Demographics
NPI:1437118254
Name:HODURSKI, DONALD F (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:F
Last Name:HODURSKI
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:PO BOX 49
Mailing Address - Street 2:
Mailing Address - City:FITZPATRICK
Mailing Address - State:AL
Mailing Address - Zip Code:36029-0049
Mailing Address - Country:US
Mailing Address - Phone:334-301-2825
Mailing Address - Fax:334-738-3260
Practice Address - Street 1:101 S UNION ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36130-3022
Practice Address - Country:US
Practice Address - Phone:334-301-2825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00005785207X00000X
FLME90799207X00000X
IN01023439A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009939391Medicaid
AL000037186Medicaid
AL510-07507OtherBCBS
AL0910073OtherUNITED HEALTHCARE
200026240OtherRAILROAD MEDICARE
AL510-37186OtherBCBS
AL000037186Medicare PIN
AL510-07507OtherBCBS